Patient Forms & Payment Information

New Patient Forms

Please fill out these forms online prior to your first appointment:

Child Patients

Adult Patients

Or, if you would prefer, print and fill out the forms and bring them to your appointment –

Print or Download

We look forward to seeing you!

Dental Insurance

We accept most insurance plans and will gladly process your claim. Please bring the necessary information with you on your first visit.

Our office is contracted with Delta Dental – we will gladly bill any other insurance as long as you can choose your own provider.

Insurance policies generally cover only a portion of the total treatment cost. Unless other arrangements have been made, we ask that you pay your portion of the bill at the time of treatment. It is your responsibility to pay any balance not paid by your insurance company.

For your convenience, we also accept payments made with your Visa, MasterCard, Discover, and American Express.

Financing is available through Care Credit

CareCredit® Dental Financing in Sacramento: We offer flexible payment options / So you can get the care you want or need

At Dynamic Dental, we’re pleased to offer our patients CareCredit, North America’s leader in dental payment plans. CareCredit lets you begin your dental treatment immediately – then pay for it over time with monthly payments that fit easily into your monthly budget. Your healthcare credit card.

CareCredit is the credit card exclusively for healthcare services. With no up-front costs and no pre-payment penalties, CareCredit lets you pay over time and frees up cash and credit cards for the other things you want or need. CareCredit offers monthly payment plans for healthcare procedures not commonly covered by insurance, including dental treatments.

Plus, you can use your card again and again to pay for additional dental treatments for yourself or family members in our Sacramento Dental practice.

  • Minimum monthly payments
  • No up-front costs, no pre-payment penalties