Patient Information for Cupertino Oral & Facial Surgery

My First Visit

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Please assist us by providing the following information at the time of your consultation: Your surgical referral slip and any x-rays if applicable. A list of medications you are presently taking. If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT

  • All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.
  • A preoperative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery.
  • Please have nothing to eat or drink eight hours prior to your surgery. You will also need an adult to drive you home.
  • Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e., heart medications, aspirin, anticoagulant therapy, etc.).

X-Rays: If your dentist or physician has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.

Insurance

Financing options

For your convenience we accept Visa, MasterCard and CareCredit. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered. If you have questions regarding your account please contact us at 408-873-8484  or email info@cupertinoofs.com. Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. A statement will be sent if there is a remaining balance after your insurance company has paid. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated.

Pickett Dental Group Financing Options

Patient Forms

Online Patient Forms

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