New Patients

 

Your first visit to Jay Freedman, DDS & Associates, PC involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. There's also background information about our committed staff . You can also save some time by printing out and completing the Health History form in advance of your appointment.

What to Do Before Your First Visit

Being well-prepared for your appointment will ensure that the doctor and staff has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web Site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.

Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.

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
  • Ensure a creative, challenging and compassionate professional environment
  • Strive for continuous improvement at all levels

Patient Forms


Please print and fill out this form so we can expedite your first visit:

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

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Dental Insurance

Is a benefit provided to about half of the USA work force. The true essence of this benefit is to provide basic care (prevention and simple restorative). Think of dental insurance as a coupon to make comprehensive and preventative care more affordable. We participate in NO insurance plans because it is Dr. Freedman’s belief that the patient and the doctor should decide on the course of treatment…. not a removed third party.

Our office has a cooperative relationship with both traditional dental insurance and Dental PPO insurance where the individual has the choice to seek care out of their network. Coleen works relentlessly to maximize our patient’s reimbursements and has over 25 years of experience.

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Financial Policy

Like most other services or products, payment is due when services are rendered. Insurance co-payments and deductibles are due at the time of services for patients with Dental PPO insurance.

WE ACCEPT CASH, CHECKS, AMERICAN EXPRESS, VISA, MASTERCARD AND DISCOVER.

Insurance Benefits

Those with dental insurance please remember that, your insurance is a contract between you, your employer and the insurance company.  You are responsible for payment regardless of any arbitrary determination by your insurance company of what is usual and customary.   If insurance payment is not received within 45 days then the entire amount becomes due and payable by you immediately.  A pre-determination is NOT a guarantee of payment. 

Minor Patients

The adult who accompanies a minor (and the minor’s parents or guardians) are responsible for full payment at the time of service.

Missed Appointments

An appointment is a confirmation that time has been reserved for your treatment.  A cancellation charge of $100.00 (per half-hour of scheduled time) is assessed for each “No Show” or appointment cancelled without 24 hours’ notice. 

Collection Costs

Checks returned from your bank unpaid are subject to a $ 35.00 processing charge.  If your account is referred for collection (after 120 days of non-payment) you will be responsible for collection costs in the amount of 35% of the outstanding balance, all certified mail costs, court costs and reasonable attorney’s fee. 

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Payment Plans

Our office offers a wide variety of third party payment plans which include several options for 0% interest and for terms up to 5 years. Almost any treatment is affordable and Coleen is available to help custom tailor a payment plan specifically for you.

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