Northpointe Dental Arts
9671 N. Nevada, Suite 200
Spokane, WA 99218
(509)468-4040 Fax: (509)468-4041
info@smilemasterpiece.com

 

 
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  Request An Appointment

Thank you for choosing our practice to serve your dental health care needs. For your convenience, we've provided this online form for you to request an appointment with our practice! First of all, let us explain a little about our office policies and goals. 
In order for our newly formed relationship to be mutually satisfying and beneficial, we ask that at any time you have a question or are unhappy about any treatment (proposed or performed), fee for service, or attitude of our “Dental Team,” you will discuss it with us promptly and openly. Misunderstandings and / or lack of communication are the only obstacles to our continued friendship and professional relationship.

Our patients can expect from us:
1. A high degree of professional skill and ability.
2. A dedication to your oral health.
3. A minimization of costly reconstructive work through proper preventative care.
4. The highest effort to make your visits as comfortable as possible.
5. The right treatment at the right time.
6. Fees that are fair and just for the services provided.

In return, we expect from our patients:
1. Cooperation in making and keeping appointments. 
2. Cancellation policy: Changes in appointment times need to be made 24 hours in advance in order to avoid a cancellation fee. (first time may be waived.)
3. A conscientious effort toward optimum oral health.
4. Recall visits to maintain optimum oral health.
5. A definite arrangement for the payment of fees at the time of service. We accept cash, check, MC / VISA, and many insurance providers. (See financial arrangements page).

For your protection, if you have a history of any of the following conditions: Mitrovalve Prolapse, Rheumatic Heart Disease, Prosthetic Cardiac Valves, Heart Murmur, Artificial Joints, you may need to take an antibiotic prior to your dental appointment. Be sure to check with your physician and always update your health history with us. 

To serve you better, we ask that you request an appointment between one and three weeks in advance.  Within a few days of receiving your request, we will contact you to confirm your appointment.  Rest assured, we'll do our very best to accommodate the appointment time that you request!

Prior to your next appointment, please take a few moments to complete the following information sheets and either bring them with you to your appointment, or mail them at your convenience at least 4 days prior to your appointment.


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*If you are in need of urgent care, please contact our office by phone.

  Contact Information
Name:
Address:
Home Phone:
Work Phone:
Email Address:
  General Scheduling Information
Month:
Day of Week:
Preferred Time Of Day:
Reason For Visit:
When was your last visit?
Please add any
comments or requests
that you may have:

We will contact you in a few days to confirm your appointment time.

*All information gathered is for internal office use only. We never share, trade or sell your information with any outside source.

   

 

   

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9671 North Nevada, Suite 200, Spokane, WA 99218
(509)468-4040 Fax: (509)468-4041
info@smilemasterpiece.com
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