Policies & Forms


(478) 986-1830

Click on forms below to view & print.

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New Patients:

New Patients Can Sign Up Online Easily!
Print, fill out, and sign the forms above and bring completed forms with you to our office.

Please remember appointment times are reserved especially for you, so if you are unable to keep your appointment, please call the office at least 24 hours in advance so that we may offer that time slot to another patient.

If you are in discomfort and call us during regular office hours, we will make every attempt to see you that same day.

We're sports fans as well.

- Hours -

Monday through Thursday

8:00 AM - 5:00 PM

Lunch from noon to 1:00 pm

(478) 986-1830

Financial Policies


For your convenience, we accept Visa and MasterCard

  1. If you pay in full (cash/check/credit card) at the time services are rendered, we can give you a discount of 5% (if you have insurance we will still file it for you, but we will have the insurance company pay you instead of us)
  2. Senior citizens (60 and over) get a 5% discount;
  3. We can file insurance and bill you for the remainder (please note that interest will be charged if the balance goes over 90 days-insurance companies often take months to pay a claim);
  4. We offer CareCredit, a convenient option to ordinary credit cards, cash and checks.


Our practice accepts most dental insurance and we participate in many plans, including most plans from Blue Cross/Blue Shield, Met Life, Ameritas, United Concordia, Delta Dental, Principal and Cigna. 

Our goal is to help you maximize your insurance benefits.  We will provide any information requested by the insurance company and provide any other help you may need.   Please understand, however, that we have no control over if, or how much, any insurance plan will pay and what they will cover.  Depending on your plan, you may be responsible for any balance remaining after insurance has paid.

If you are not sure about the details of your plan, call and we can help answer any questions you may have.


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Copyright Dr. Kenneth Kay, DMD