Natural Dentist Patient Resources

Out of respect for our chemically sensitive patients, we request that you refrain from wearing perfume or scented products in this office.

New Patient Forms

Please click on the link below for the .pdf to print and bring in to your appointment. Each form is needed per patient for his/her file. Let us know if you have any questions.

Adults
- New Patient Information Sheet
- Pre Treatment Questionnaire
- Hipaa Statement of Privacy Practices
- Medical History

Children
- New Patient Information Sheet
- Hipaa Statement of Privacy Practices
- Medical History

Insurance
We are not a preferred provider or in contract with any insurance company. However, as a service to you we will bill your insurance company for you. Most insurance covers a portion of fees.

Estimated patient portion will be due at time of service. Ask your insurance company what they will pay for “out-of-network” providers.

Important insurance information
When you are quoted a percentage of an “allowable amount,” this means the allowable amount according to the plan you have signed up for with your insurance company which is generally lower than the fees at our office.

The remaining amount is considered “out-of-pocket” and is due at the time of service and will be corrected once your insurance contacts us with their “allowable amount” and billed to you. This can take a couple weeks or more to be adjusted by your insurance company.

If a necessary or optional treatment plan is needed, it will be provided at your appointment and an assistant will go over it with you before treatment is rendered.

Trauma Free New Experiences
Many patients arrive with some emotional memories from the past.

Dr Saepoff will find out in the early visits what troubles you and go to lengths to create a treatment experience intentionally different.

Just tell us whatever it is and we will adjust everything so you can have a fresh easy appointment that is nothing like what you remember.

The New Dental Mainstream
In the new mainstream the least toxic and least invasive choices are the norm.

In the new mainstream you are given all the time you need to gather information and make choices that work for you and your family. Dr Saepoff will let you know everything that is possible for your teeth.

In the new mainstream the health of our beautiful and precious planet earth is considered in all actions that might affect her.

In the new mainstream you have freedom to make treatment choices without pressure or infringement of any kind.

Ask Dr. Saepoff questions!
Dr. Saepoff has her own radio show where she answers questions about dentistry. To submit a question for the show, please send an email to questions@naturaldentist.com. For questions related to appointments, send an email to appointments@naturaldentist.com.