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FILL OUT FORMS

dear patients,

WE ARE SO HAPPY YOU ARE HERE!

We are so excited that you have chosen our practice to meet your dental needs! 

 

Click below to either fill out all of your forms online. Make sure these are filled out prior to your first appointment. Please make sure you have your insurance card and license with you at your first visit. We look forward to meeting you soon!

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apply now!

FINANCE YOUR SERVICES WITH CARE CREDIT

Carecredit is a third party personal care credit card that allows patients to pay their treatment cost down at no interest for up to 12 months. For an extended payment plan, we gladly offer CareCredit. For more information about this option, click here.

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*No interest if paid in full within 12 months on qualifying purchases with your CareCredit credit card at enrolled provider and select retails locations in the CareCredit Network. Interest will be charged to your account from the purchase date if the promotional purchase is not paid in full within the promotional period.

MAKE A PAYMENT

MAKE A PAYMENT

We are committed to helping you maximize your insurance benefits. We are a PPO only network provider & only in network with PPO plans with the following insurance companies; Blue Cross Blue Shield of Alabama, Southland, Aetna, Cigna, Metlife, United Concordia, Guardian, and Humana. Every contract is different, however, we will do our best to give you an accurate estimate of your co-payment. This must be paid at the time of service. Despite our best efforts to give you an accurate estimate, occasionally insurance will pay less than the approximation. The patient is responsible for any amount that is not paid by their insurance.

Methods of Payment, Patient Information

At Kasey Davis Dentistry, we are committed to providing quality and affordable dental health care. We accept cash, Visa, Mastercard, Discover, checks, and insurance.

 

For an extended payment plan, we gladly offer CareCredit. For more information about this option, click here.
 

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