Forms & Financing

New Patient Forms

  • New Patient Information
  • HIPAA 
  • COVID-19 Screening & Protocols

All of the above forms and more can be easily completed from the comfort of your home prior to your appointment! All forms will be conveniently emailed or texted to you shortly after you schedule an appointment with us.

Pay Online

  • Take Care of Services Through Our Secure Online Payment System
  • Put A Credit, Debit or HSA/FSA Card On File To Simplify Payment
  • Change Your Mode of Payment as Needed & Keep Track of Receipts Digitally!

Payment at DublinPDO is made simple thanks to our easy-to-use online system! All of your detailed treatment statements, payment link, and receipts are directly emailed or texted to you.

We Accept Most Dental Insurance Plans!

Make Oral Care Easy With Insurance

DublinPDO team is happy to submit claims and provide estimates for your treatment. We will work together with your family so you can feel confident knowing that our billing is transparent and explanations are provided.

Our office participates with most major PPO plans including, but not limited to:

  • Aetna
  • Ameritas
  • Anthem
  • Blue Shield of CA
  • Cigna
  • Delta Dental
  • Guardian
  • Humana
  • Level
  • UHC (United Healthcare)
  • Zelis
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third Party Lenders

Accessible financing

We are committed to helping keep our high-quality care as convenient and accessible as possible. That's why we offer our families the option to finance their treatments with CareCredit, one of the nation's most-reputable third-party lenders. To learn more about your financing options, contact us today!

In-House Payment Plan

FLEXIBLE PAYMENT OPTIONS FOR YOUR ORTHODONTIC TREATMENT

DublinPDO offers flexible monthly payment plans for your child's orthodontic treatment. Our front office coordinator is happy to answer all billing questions you may have and provide detailed explanations to help make your payment process as smooth and clear as possible!

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Comprehensive Orthodontic Consultation

Includes:

Exam

Dr. Liz will thoroughly exam your child's bite and oral development to see what orthodontic care they may need now or in the future.

Consultation

After the exam, you'll get one on one time with Dr. Liz where she will go over the findings of the exam with you. This is also a good time to ask any questions you may have!

Treatment plan

Dr. Liz will lay out all possible treatment options if any are needed. Together, you will develop a treatment plan that covers your child's needs and works within your budget and lifestyle.


*Additional Orthodontic Records typically taken at a separate records appointment, including but not limited to digital radiographs, intraoral scan, and clinical photos, will be needed for a definitive orthodontic treatment plan.

Frequently Asked Questions

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We Care For Your Little Ones As We Would Our Own