Patient Forms

[vc_row][vc_column][vc_column_text][mc_icon class=’single’ url=’https://www.facebook.com/kurtkweberddspa/’ icon_social=’facebook’ icon_color=’blue_light’][mc_icon class=’single’ url=’https://plus.google.com/+KurtWeberDDSPAStPetersburg/about’ icon_social=’googleplus’ icon_color=’blue_light’][mc_icon class=’single’ url=’https://twitter.com/KurtKWeberDDS’ icon_social=’twitter’ icon_color=’blue_light’][/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_empty_space height=”1px”][/vc_column][vc_column width=”1/4″][vc_empty_space height=”1px”][/vc_column][vc_column width=”1/4″][vc_empty_space height=”1px”][/vc_column][vc_column width=”1/4″][vc_btn title=”Request an Appointment” color=”blue” align=”center” link=”url:http%3A%2F%2Fkurtweberdds.com%2Fappointment%2F||”][/vc_column][/vc_row][vc_row][vc_column width=”1/6″][vc_empty_space][/vc_column][vc_column width=”2/3″][vc_empty_space][vc_column_text]

Patients

 

32 years of professional experience, Kurt K. Weber, D.D.S., P.A.

” A Beautiful Smile For You!”.

[/vc_column_text][vc_empty_space height=”16px”][vc_single_image image=”3160″ img_size=”large” alignment=”center” onclick=”custom_link” link=”http://kurtweberdds.com/patients/specials/”][vc_empty_space height=”16px”][vc_empty_space][box_header title=”What to Expect” bottom_border=”1″ animation=”0″][vc_empty_space height=”16px”][vc_column_text]On your first visit to our St. Petersburg or Seffner dentist office and once every year, you will need to fill out the required forms, which can found below. Being well-prepared for your appointment is also paramount to your health as the doctor will use these forms to provide the best possible care for you. To help with any anxiety, please educate yourself with our services and review our accomplished doctor and a staff.

In addition, your insurance is a method for you to receive benefits or reimbursement of fees for physician or material services rendered. Having insurance is not a substitute for payment. It is your responsibility to know your insurance and pay in advanced any co-payments, deductible or other balances not covered by your insurance plan.

Many offices, Dr. Weber’s included  will assist you in verifying your insurance prior to your appointment if provided with the proper information. Should you choose to keep your appointment without obtaining prior authorization, any services rendered or materials ordered will be your responsibility to pay for personally and then collect directly from your insurance company.[/vc_column_text][vc_btn title=”Testimonies” color=”primary” align=”right” link=”url:http%3A%2F%2Fkurtweberdds.com%2Ftestimonies%2F||”][vc_separator][vc_empty_space height=”16px”][vc_row_inner][vc_column_inner width=”2/3″][vc_empty_space height=”16px”][box_header title=”Form Downloads” bottom_border=”1″ animation=”0″][vc_empty_space height=”16px”][vc_button title=”Personal Info / Medical History Form” size=”large” target=”_blank” icon=”wpb_shield” text_color=”#ffffff” hover_text_color=”#ffffff” color=”#0384ce” hover_color=”#42b3e5″ href=”http://kurtweberdds.com/wp-content/uploads/2013/04/Personal-Info-Medical-History-Form-2017.pdf”][vc_empty_space height=”256px”][/vc_column_inner][vc_column_inner width=”1/3″][/vc_column_inner][/vc_row_inner][vc_separator][vc_empty_space][/vc_column][vc_column width=”1/6″][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][box_header title=”Insurance & Billing” bottom_border=”1″ animation=”0″][vc_column_text]We accept most traditional insurance plans. Check our list of accepted insurance networks. Kurt K. Weber, D.D.S., P.A. does not participate in Health Management Organizations; however, we will be happy to file your insurance claims for you. We accept cash, Checks, credit cards and offer a payment plan via CareCredit.[/vc_column_text][/vc_column][vc_column width=”1/3″][box_header title=”Accepted Insurances” bottom_border=”1″ animation=”0″][vc_column_text]Our offices do not accept Medicaid, Medicare or any HMO, DPO, DMO plans.

Networks
Aetna, Ameritas, Ameriplan (discount plan), Assurant, Bluecross Blueshield (all states), Fl-Blue Dental, Cigna, Connection Dental, Delta Dental (all states), Delta Tricare (PPO & military retiree), Metlife, Principal, The Lincoln, United Healthcare, United Concordia. Please call us as our accepted insurances may change. Updated 2/9/2016[/vc_column_text][/vc_column][vc_column width=”1/3″][box_header title=”CareCredit” bottom_border=”1″ animation=”0″][vc_column_text]CareCredit is a financial option to help you pay for treatments and procedures that your insurance will not cover. CareCredit offers interest free financing or low monthly payment options. After 20 years, CareCredit has help 20 million cardholders get the treatments they need. For more information or to apply, visit Carecredit.com[/vc_column_text][/vc_column][/vc_row]