Professional Mobile Dental Hygiene Services
All you need is the invoice number from the bill we sent you and your credit card of choice.
We accept Paypal, Mastercard, Visa, American Express, Discover, or you can set up an e-check payment from your Paypal account.
Patients Last Name
The 3rd form is only needed for Patients that need physicians clearance prior to a cleaning. If you are unsure, print it out, and just fill in the Dr. name and phone number portion and we will do the rest.
Step 2. Fill out forms
Step 3. Sign and return the forms by mail. You will be contacted promptly to set up an appointment that is convienient for you.