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New Patients - First Visit

Welcome to First State Dental

First State Dental is accepting new patients. Whether you need to have your teeth cleaned or you would like a total smile makeover, you have come to the right dental practice. Our primary goal is to create and maintain the dental health of our patients. We are focused on your dental needs and desire to create a beautiful healthy smile.

New Patient Forms

The following patient registration forms can be downloaded to your computer, printed, and completed in the privacy of your home. In order to provide a complete and comprehensive examination, consultation, and treatment plan, it is important to review all your medical information, including medications you take.

Please be prepared to provide this information to our office along with your current dental insurance information so that we may use our expertise to assist you in maximizing your dental benefits.  Below is a link to our patient registration forms. If you have any questions about these forms, our staff will assist you with your questions on the day of your visit.

Effective May 1, 2016

First State Dental designates Karen Coho as:The Privacy Official, responsible for developing and implementing the dental practice’s privacy policies and procedures, and as the person responsible for: receiving complaints, providing further information about the Notice of Privacy Practices (for example, to patients, staff, etc.), and receiving and processing:requests for access, accountings of disclosures, and requests for amendment.


We accept Cash, Check, Visa, Master Card, Discover, Financing, and Care Credit.

payment methods


Care Credit

Care Credit is a health care credit card. Care Credit applications can be made through our office for 1) interest-free payment plans up to 12 months and 2) low interest payment plans of 24 to 60 months. See: Care Credit Application


We accept all insurance. First State Dental is not a network provider.


Financial Responsibility Policy

As a result of the many different and confusing insurance company reimbursement policies, it is necessary to have an easily understood financial responsibility policy.

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