In order to expedite your first visit, our website provides the paperwork needed so we may open a chart for you. Please fill out the following (secured) new patient forms and we will verify your insurance prior to scheduling your appointment so we can ensure not only that we are providers for your plan but also to expedite your wait time once you come to your appointment. You also have the ability to schedule your appointment before sending the forms but we require that you submit the required forms with at least 72 hours prior to your appointment to ensure and confirm your scheduled time. On your first appointment to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Note to Patient: Upon filling out your first name, last name, email and at least one phone number field (a valid home or cell phone) a button will appear in the upper right corner titled “Save and Exit” . This button allows you to save and exit your form to complete at a later date. The system will send a registration email to the email provided on the form, so that you may setup a login to go back and finalize your registration form online.
Registración de Paciente
Usted se puede prerregistrar con nuestra oficina a través de llenar nuestro formulario Seguro en linea de registración de pacientes. Después de haber completado el formulario por favor asegúrese de presionar el botón de Complete and Send al fondo del formulario para enviarnos su información automáticamente. La seguridad y privacidad de sus datos personales es uno de nuestras preocupaciones principales y hemos tomado cada precaución para protegerlos.
Nota al paciente: Al haber llenado su primer nombre, apellido, dirección de correo electrónico y por lo menos una sección de número telefónico (un número válido sea de hogar o de celular) un botón aparecerá en la esquina derecha superior con el título “Save and Exit“. Este botón le permite a usted salirse de la página y aun conservar su formulario para completarlo en una fecha posterior. El sistema enviara un correo electrónico de registración a la dirección de E-mail cuál usted haya proveído en el formulario para que pueda configurar una contraseña para regresar y finalizar su formulario de registración en linea.
- If you are scheduled for a TMJ visit please print the TMJ Form
We suggest that you arrive early (15 minutes) prior to your scheduled appointment. This allows you time to find parking and our office, directions .
Please bring the following documents to your appointment unless you have ideally submitted these to our office.
- A complete list of your current medications. It’s okay to bring the bottles with you.
- Your doctors’ names and phone numbers. Your total health is very important to our practice and we will work with with your medical team to keep them abreast of any matters that may be of importance to your total well being. This would include your Dentist, Orthodontist, Primary Care physician, and Cardiologist.
- A parent or legal guardian if you are under 18. Please note that the parents name and signature that you place on the form needs to be the parent that brings you to your first visit.
- Identification, such as a driver’s license.
- Insurance information, your dental and medical insurance cards must be brought to your 1st appointment.
- The referral slip your dentist/doctor/orthodontist gave you and any X-rays your dentist has taken. We’ll take additional X-rays, as needed.
All of this will hopefully lead to a prompt and stress-free first visit with us. Although, Dr. Eisner is a surgeon and at times length of a surgery cannot be exactly pre-determined we strive to be on time for your appointment as we know your time is valuable. Our practice is appointment based but based on the nature of the specialty we will always do our best to work in to our schedule emergency patients within 24 hours. We look forward to providing you and your family with the highest quality medical care in a professional setting.
We want you to be knowledgeable about your needs and the procedures that you need performed. When you become a patient of our practice, your first appointment is a personal consultation with Dr. Eisner. Unless you require an emergency procedure, procedures are typically not performed at the first visit. Instead, you will have the opportunity to meet Dr. Eisner and discuss your options for the treatment you may need and any concerns you may have in order to make your surgery experience one that is safe, secure, and comfortable. You will meet his administrative staff that will be able to give you all the insurance and financial information you will need to be prepared for the procedure. You will also meet Dr. Eisner’s surgical team who will discuss at further length with you how to prepare for your procedure and what to expect after your procedure.
This way when you come back for your surgery you will have had the time to evaluate all your options and prepare calmly for your procedure.