Welcome! Your first visit to Keizer Smile Center involves a few special steps so that we can get to know you. Please bring your current list of medications, the contact information for your primary care physician, and insurance information. New patient forms (see below), printed and completed in advance can also streamline your experience. Also, if you have had recent dental x-rays, please have them sent to our office, if possible. We look forward to meeting you. See you soon!
Please print and fill out these forms prior to your first visit:
In order to view or print these forms you may need Adobe Acrobat Reader installed. Click here to download it.
Insurance and Billing
- Payment is expected at the time of service.
- We accept checks, cash, or Visa, MasterCard, and Discover credit cards.
- We also offer a flexible third party payment plan through Care Credit (see financing options below).
- We can submit dental insurance claims to any company for you for your convenience.
- We are currently directly "in-network" providers for Aetna*, Cigna**, Delta Dental, MetLife, Moda and Regence PPO plans.
- Keizer Smile Center is not an OHP/Medicaid provider.
- For more information, see our office financial policy.
*Note that Aetna has multiple indirect agreements with other insurnce companies, so we are also indirectly in-network for patients with dental PPO coverage issued or administered by:
- Ameritas Life Insurance Corp. and Ameritas Life Insurance Corp. of New York
- Standard Insurance Company and The Standard Life Insurance Company of New York
- Reliance Standard Life Insurance Company and First Reliance Standard Life Insurance Company
- Physicians Mutual Insurance Company
- Principal Insurance
**Note that Cigna has an agreement with GEHA Federal insurance plan and we are indirectly in-network with them as well.
CareCredit is here to help you pay for treatments and procedures your insurance doesn’t cover. CareCredit offers financing or low minimum monthly payment options. With three simple steps, including an instant approval process, it’s easy to apply for CareCredit. After you’re approved, you’re free to use CareCredit for the dental services you choose. With CareCredit, the decision’s in your hands to get what you want, when you want it. For more information or to apply online, visit our CareCredit Website here.
Keizer Smile Center is committed to providing gentle, quality dental care to each of our patients with the same care and compassion we want for our families and ourselves.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Smile often :)
We treat all people with fairness and respect, including all government recognized protected classes and groups.