In Office Benefits Plan
We are pleased to offer an In Office Benefit Plan for our patients who do not have dental insurance. Our plan has NO waiting periods, NO deductibles, and NO annual maximums. Our discount plan aims to save costs on your dental treatments performed at our offices. These services include routine hygiene appointments, dental fillings, crowns, implants and select periodontal surgical services.
Please call our office directly to inquire about pricing (206) 546-4109
Prophylaxis Plan (for patients with healthy gums) | Periodontal Plan (for patients with gum disease) |
2 annual dental prophylaxis cleaning | 3 annual periodontal maintenance cleanings |
BOTH PLANS INCLUDE THE FOLLOWING: | |
2 routine dental examinations | |
All necessary routine dental x-rays | |
2 fluoride varnish applications | |
1 complimentary emergency exam and x-ray when definitive treatment is completed on the same day as diagnosis | |
15% discount on general dental procedures (e.g. fillings, deep cleanings, nightguards) | |
15% discount on crowns, bridges, implants, and associated implant crown restorations | |
15% discount on cosmetic services including dental veneers and custom whitening | |
15% discount on select periodontal surgeries including: extractions, bone grafting, soft tissue grafting and surgical periodontal therapy |
Payment for all services are due and payable at time of service. Advance notice of at least 48 business hours is required for any missed or cancelled appointments. Any appointments missed or cancelled within 48 business hours are subject to a fee of $135 per hour reserved.
Restrictions: This plan is intended for patients requiring routine care. Complex full arch restorative & implant cases are excluded from the above discounts.
Plans will be valid 365 days from signed start date. Yearly payment is due upon start date.
Print Name: _______________________________________________________________
Signature: _________________________________________________________________
Start Date: ________________________ Exp Date: ________________________________
This plan is valid only at our associated dental offices: Park Place Dental, Bothell Smiles Family Dentistry, North Seattle Implants & Periodontics