We do not participate with HMO’S. Please check with your insurance carrier to confirm that we are a participating provider with your plan. It is your responsibility to know your own coverage. We cannot always make phone calls on your behalf to determine your eligibility or benefits prior to your appointment.
Most insurance plans still require you to pay a portion at your child's appointment.
As a courtesy on your behalf, we will submit claims to any insurance plan that has coverage for dental or orthodontics.
To prevent surprises, we encourage you to double check with your insurance company prior to your child's first visit.
A Note to New Patients
We're thrilled you chose Frederick Pediatric Dentistry as your child's new dental home. If you're a new patient to our practice and you're unable to bring your forms with you to the appointment, we just ask that you arrive 10 minutes early to complete the paperwork. We understand that sometimes things come up, and there indeed is considerable traffic around Frederick at certain times of the day. Our team works hard during your child's appointment to ensure you and your children are given plenty of time to ask any questions and be completely comfortable. By arriving on time, you help us give your children the best quality of care- it's time you deserve. If you find that you're going to be late at the last minute, please call our office and we will do our best to accommodate you.
Download these forms and fill them out prior to your arrival to help us see you faster.
New Pediatric Dentistry Patient Forms (Orthodontic Patients, Please See Below)
Returning Pediatric Patient Forms
- Medical History Update
- Power of Consent Form (if someone other than the parent is bringing the child; i.e. grandparent)
Nitrous Oxide and Sedation Forms
Same Day Surgery and Hospital Forms
- Frederick Memorial Hospital History and Physical Form
- Frederick Memorial Hospital Non-Staff Preop History and Physical Privileges
- Frederick Memorial Hospital Non-Credentialed Physician Letter
- Same Day Surgery Instructions