Forms / Insurance

New Patient Forms

Please bring filled out forms to your first appointment.

Dr Reyes New Patient Info Form

Dr Reyes New Patient Financial Policy

HIPPA Consent

HIPPA INFO

Kindergarten Oral Health Assessment

Please bring this form with you to the appointment if your child needs a screening for kindergarten.
Oral Health Assessment Form

For more information please see California Department of Education.

Insurance Information

We make every effort to keep dental care affordable while maintaining the highest level of quality. We will never compromise your child’s care based on what an insurance company says.

Know that dental insurance is designed to defray SOME of the costs of dental care by paying only a portion or percentage of the bill.

Dr. Reyes is signed up as a “Preferred Provider” for Delta Dental Premier. We are constantly exploring other insurance provider plans. Please let us know who your provider is so that we may evaluate and possibly negotiate to be a designated provider.

Our commitment is to serve you rather than insurance companies. Ultimately, your insurance company is responsible to you. Unfortunately, we cannot make any guarantees or promises on behalf of your insurance company.