The best way to set up your first appointment is to call the office so that we can gather all necessary information to help make your first visit easy and comfortable. The New Patient Intake Form Below will give you all the information we will need.
Your first visit to Eugene B. Nichols, DMD establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.
Nichols Family Dentistry believes in going back to the roots of quality health care. We know every person's dental needs are unique. That's why we offer a comprehensive selection of treatment options in a comfortable, relaxing atmosphere. We are confident that we can provide superior dental care for today's busy patient.
Honesty, integrity, and quality. We never compromise our principles.
For your convenience, you can download and complete our Patient Forms before your visit.
- Patient Registration Online Form
- Medical History Online Form
- Patient Information Release Online Form
- Patient Liability Online Form
- Transfer of Records
- Notice of Privacy Practices
- New Patient Intake Form
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it:
What to expect at your first visit
Welcome to Nichols Family Dentistry. It will be a pleasure to show you our facility. Take some time to review our staff page and familiarize yourself with your care team. We look forward to your first visit.
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible treatment plan. Please print and complete, or fill out online, the following forms before your appointment.
- Patient Registration
- Patient Liability
- Medical History
- HIPAA Notice
- HIPAA authorization
- Transfer of Records
**Please note that all records and xrays need to be received by this office prior to your first appointment. If you have not given the information for your insurance, please call the office so that coverage information can be obtained prior to your appointment.
What Insurance information do you need to provide? We make every attempt to verify coverage prior to your first visit, so this information is needed when you book your appointment.
- Name of the Subscriber
- Subscriber's Employer
- Subscriber's Date of Birth
- Subscriber's Member ID
- Group Plan ID
- Insurance Company, Plan Name and Insurance Claim Address.
Your first visit will take approximately 1 hour. You should arrive 10 minutes prior to your appointment to make sure all paperwork is completed and in order. During this visit, a complete chart of your existing fillings, crowns, etc. will be made. X-rays, if needed, will be taken, a cleaning, a periodontal exam will be completed and a comprehensive exam by the doctor will be performed. This time is reserved just for you, so that we can give the best oral care.