New Patient Information Form.
The attached checklist will help to list the items we ask you to bring to your first appointment. Please download and bring with you to your appointment.

Financial Policy:
For your convenience we accept the following forms of payment:

• Cash
• Check
• Visa, Mastercard, Discover, and American Express

Patient Financing Options:
Dr. Vakay understands that patients can have budgetary requirements, and therefore we offer healthcare finance programs to help you with your dental care needs.  Long term financing is available through our dental office provided by Capital One, which offers:

• Payment options to fit within your budget
• No application fee or initial payment
• Fast, easy and confidential

For more information please visit www.feeplan.com, or call our office today.

We are committed to providing excellent dental care and we strive to keep our fees affordable.  We kindly request payment at the time of service to reduce costly billing procedures.

Heath Insurance Plans:
Although, we do not participate in any dental insurance plans, we are happy to file insurance forms as a courtesy to our dental patients. Please be fully acquainted with your policy. Bring your card to your appointment.

Thank you for your interest in contacting us.
If you could fill out the appropriate information below, we will be in contact shortly.