Dr. Julie D. Messerly DDS
Patient Forms:   Please print and complete BOTH pages and bring them to your appointment. 

We will work with you to maximize your dental insurance benefits.  In order to bill your dental insurance for procedures completed, we will need the Insurance company name, group number and claims mailing address.  We will also need the insurance subscribers information including Social Security number and date of birth.

We ask that you keep us informed of any changes to your Dental Insurance. 
We offer a 10% discount to all patients that do not have dental insurance and pay at the time of service.
Our office manager will be happy to discuss payment arrangements with you that hopefully meet your needs. We accept cash, check, Visa, MasterCard, and Discover for the payment of our fees.

Financing for treatment is available through CareCredit. The application must be completed online. We will be happy to help you complete application during your appointment if you need assistance.

CareCredit Apply Online