New Patient Form – Printable version
Please download, print and fill out the New Patient Form (PDF) below and bring it with you to your first visit.
New Patient Form – Printable version
New Patient Form – Online Web form version
Please click the links below of each form, fill out online, submit and let us know(info@primecare-dental.com, (702) 369-8730).
1. New Patient Registration Form
Insurance and Payments
We value each and every patient at Prime Care Dental, and we want to make it easy to pay for your dental care. To that end, we accept numerous payment methods, including: debit and credit cards, cash, and checks.
We also participate in most major PPO insurance plans, such as
Delta, Medicare(Dental supplemental plans), Diversified, Health Scope, Liberty PPO(MGM Choice, Venetian PPO), UMR, Principal, Humana, Ameritas, Aetna, Anthem, Cigna, GEHA, Guardian, Metlife, UnitedHealthCare, Sun Life, etc.
Unfortunately, we DO NOT accept Medicaid.
Patients without Insurance
We are happy to offer various ways to help our patients without insurance.
Prime Care Dental provides offer Care Credit(instruction can be provided in office), installment plans for flexible financing.
For any financial or payment questions, please don’t hesitate to call us at (702) 369-8730.