Welcome to our office!
Patient Forms, Map and Directions to Clemmons Office
Your first visit to Clemmons Comprehensive Dental Care establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment. Mission Statement Our practice is working together to realize a shared vision of uncompromising excellence in dentistry. To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Patient Forms Please print and fill out these forms so we can expedite your first visit:
Privacy Practices (these are for your records, and do not need to be brought to your appointment): Page 1 Page 2 Page 3 Page 4
What To Expect Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctor and staff. We look forward to meeting you!
What to Bring Please print and fill out the patient forms above. If you cannot print these forms out, please call our office and we would be happy to mail the forms to you ahead of time. Alternatively you could stop by our office to pick them up. Once completed, the forms can be mailed back to us, faxed to us at (336)293-6674, or scanned and emailed to us at [email protected].
Dental insurance verification can be a lengthy process. This too can and should be done before your initial visit. Please mail, email or fax a copy of the front and back of your insurance card, and we would be happy to verify your benefits ahead of time. Alternatively you could call our patient care coordinator, Alex Saucedo at (336)293-6623 and give her your insurance information over the phone.
Please bring a picture ID, such as a driver's license with you to your initial appointment.
We file insurance with most insurance companies on behalf of our patients. For patients who do not currently have insurance, we are offering the following specials:
New Patient Special (Adult) $239
Includes thorough adult cleaning, full mouth series of digital x-rays, comprehensive oral exam with cancer screening and treatment plan. Does not apply to patients requiring periodontal therapy.
New Patient Special (Child) $149
Includes thorough child cleaning, bitewing x-rays, fluoride treatment, comprehensive oral exam with cancer screening and treatment plan.
We offer Care Credit. To submit an online application directly to our office, please click here.
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