Forms


Thank you for choosing North Point Pediatric Dentistry. We are excited to have the opportunity to care for your most valued treasure in our practice. Please complete all necessary forms and consent documents in their entirety at least 48 hours in advance of your appointment time. Failure to do so may result in the appointment being canceled and rescheduled for another date. All documentation must be completed by a parent or court appointed legal guardian, no exceptions. Failure to complete all necessary forms may require information to be completed once again, in office. Please call and verify that all required documentation has been received, prior to your appointment time to ensure receipt. If you have any questions, please contact our office and we will be happy to help you. Please note: If we are not filing Insurance through Hoosier Healthwise or Hoosier Care Connect, you do not need to fill out the Medicaid Insurance Form. We look forward to meeting your family soon!

 

Insurance Card Uploader

NOTE: All insurance information/updates must be submitted at least 2 business days prior to dental appointments. Without proper time, we may not be able to verify benefits and could result in out of pocket costs. For questions, please email insurance@northpointkids.com.

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