darker background

Consent and Financial Agreement Form

Understanding and agreeing to treatment terms, financial responsibility, and privacy policy.

pretty young woman with cute smile

Read the form carefully

Review and Sign

Before proceeding with any treatment, it's essential to understand and consent to our terms. This form outlines financial responsibilities, treatment plans, and privacy policies for your acknowledgment and agreement.

Contact Us Today!

We're not your average dental clinic - we're your partners in oral health. Feel free to give us a call to book your appointment with our dentist at Progressive Dentistry and take the first step towards achieving your perfect smile.
man smile with arms crossed
We will make you smile logo
Mon, Wed & Fri: 9:00am - 5:00pm
(Closed for lunch 1-2pm)
Tue, Thu & Sat: Closed
We Accept
care credit white