Forms & Financials

Detailed financial information and new patient forms

Financial Information

The cost of your orthodontic treatment may vary depending on your individual needs and treatment plan. Dr. Silvana Gonzalez and her team will discuss with you the cost of your treatment and each of your available payment plan options so that you are able to make the best choice for you, and your smile. We will work with you to create a payment plan that fits your budget, and you will know what to expect before beginning treatment.

Affordable Payment Plans

Your smile is yours forever, and we want to make it as easy as possible for you to receive the best orthodontic care whenever you need it.

** Our practice accepts most major credit cards and insurance plans. **

Our office staff is always available to help you with insurance claims and paperwork, if you have insurance that will be covering any portion of your orthodontic treatment.

Please let us know if you have any questions about your insurance coverage and how we can help to make your entire orthodontic experience a pleasant one.

Convenient Online Services

With just the simple click of a mouse, our secure online service allows you to:

  • View your appointment and account information any time;
  • Sign up for email or text appointment reminders;
  • Check your payment history and see current charges;
  • Print out flex spending reimbursement and tax receipts.

If you do not have a patient log in and would like to begin viewing your account information online, please click here to sign up for your own personal account.

Complimentary Consultations, Affordable Payment Plans, Low Monthly Payments (Always Interest Free), No Down Payment Interest-Free Financing

Providing a higher-standard of care also means making your orthodontic treatment affordable. The cost of your orthodontic treatment may vary depending on your individual needs and treatment plan. Dr. Gonzalez and team will discuss with you the cost of your treatment, and each of your available payment plan options, so that you are able to make the best choice for you, and your smile. We understand that orthodontic treatment is a sizable investment, so we will work with you to create a payment plan that fits your budget, and you will know what to expect before beginning treatment.

We offer:

  • Interest-free financial payment plans throughout treatment
  • Automatic credit card or bank draft payments through OrthoBanc
  • Discount for paid in full

Does your employer offer a flexible spending plan? If so, we can contribute these pretax dollars towards your orthodontic expenses!

Forms

Please take a minute to print and fill out the patient information form before your first appointment:

If you’re unable to open PDF files, you can get Adobe Reader® for free.