Patient Resources: Forms & Policies
When you come to Dr. Gibson’s office in Orlando, we will have new patient forms ready to fill out quickly before your visit. Or, for your convenience, you can click on the links below and fill them out before you arrive. The Notice of Information Practices and Privacy Statement is for your information only and does not need to be returned. Please be sure to also bring any insurance cards or payment information that you may need for your appointment.
For your convenience, Gary Gibson Dental accepts cash, personal checks, money orders, and most major credit cards. Payment is expected at the time services are performed. Feel free to contact our office if your treatment plan requires more comprehensive dental work and you want to discuss financial arrangements.
We offer CareCredit™ to help you pay for treatments and procedures your insurance does not cover or that are too costly for you to pay for out of pocket. CareCredit™ offers No Interest financing or low minimum monthly payment options so you can get what you want when you want it. With three simple steps, including an instant approval process, choose CareCredit to finance any services you choose.
As a service to our patients, our practice accepts most dental insurance programs, including non-managed care, indemnity (traditional), and PPO out-of-network. We are not part of any managed care network. Our accounting staff will prepare all the necessary forms for your dental benefits. However, we remind you that your specific policy is an agreement between you and your insurance company. Please keep in mind that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. Our staff will gladly submit a pre-treatment estimate to your insurance company so that you will know what your benefits will be. The fees charged for services rendered to those who are insured are the usual and customary fees charged to all our patients for similar services. Your policy may base its allowances on a fixed fee schedule, which may or may not coincide with our usual fees. You should be aware that different insurance companies vary greatly in the types of coverage available. Also, some companies take care of claims promptly while others delay payment for several months.
Fill out the forms below to save time during your appointment.
Adobe Acrobat or another pdf viewer is required to read our patient forms. If you have trouble seeing the document or need accommodation, please contact our office. Click here to download the Adobe Acrobat software.
In addition to our own website, there are other sites that may prove informative for you. If you’d like further information about general preventive care, implants, cosmetic dentistry, or dental training and continuing education, please view the links below.