Self Referral Form
Notice of Privacy Practices
Financial Policy & Insurance Information
Doctor Referral Form
Patient Registration Packet
Frequently Asked Questions
Preparing for Your Appointment
Your appointment time is reserved specifically for you. Every effort will be made to see you on-time.
• The initial visit, with the exception of certain emergency cases, is for consultation only. This enables us to fully evaluate your condition, concerns, needs, and desires so that we can develop an appropriate treatment plan that is custom tailored for you.
• Patients under the age of 18 must be accompanied by a parent or legal guardian at the time of initial consultation.
• Please bring all pertinent medical information, names/telephone numbers of your physicians, and a list of all medications you are taking.
• If you have dentures or occlusal splints/guards (even if you do not wear/use them), please remember to bring them with you to your appointment.
• Please complete your registration paperwork online at www.premieroralfacialsurgery.com prior to your appointment, or arrive at least 15 minutes in advance of your scheduled appointment in order to complete the necessary documentation.
• If you must cancel/reschedule your appointment, please notify our office at least 1 day in advance.
Patients Desiring IV Sedation/General Anesthesia
• Patients will not be sedated on the first visit to our office. Sedation/General Anesthesia requires an initial consultation first.
• Patients undergoing IV Sedation / General Anesthesia cannot drive themselves home or operate a vehicle/heavy machinery for at least 24 hours following the procedure.
• A responsible adult driver must accompany the patient, and remain in the office for the entire duration of the procedure. The driver cannot leave and come back.
• For safety, the patient must have an EMPTY STOMACH for 6 hours, taking nothing by mouth, not even water prior to Sedation/General Anesthesia.
• Your doctor will instruct you on which medications to take at the usual prescribed times. If medications are to be taken prior to Sedation / General Anesthesia, they are to be taken with only a small amount of water.
Financial Policy & Insurance
• We understand and appreciate your financial concerns. We believe our fees are commensurate with our levels of education, expertise, technology, the quality of materials we use, and the exceptional care we provide.
• Our doctors are not contracted with any insurance carriers. This permits us to have an unbiased approach to your care in order to offer you our honest opinions and best services.
• You will not be surprised by any hidden fees. We will provide you with a detailed written treatment plan. Before any treatment is performed we will inform you of the costs.
• Payment is required at the time of service. We accept cash and all major credit cards. Personal checks are not accepted. If extended payments are required, financing options are available.
• We have specially trained staff members dedicated to assisting you with financial arrangements, financing options, and filing your insurance claims.
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Get In Touch
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Sat & Sun: 8am-7pm
Schedule Your Consultation With Us Today
Please contact our office today at 407-553-2894 to schedule your appointment with one of our Lake Nona oral surgeons.