As a convenience to our patients, Finer Smiles Dental is pleased to offer online pre-registration which will assist us in preparing for your upcoming dental visit. Pre-registration is not required, but doing so will expedite your check-in by reducing questions during the registration process.
IMPORTANT: This online pre-registration process will not schedule your appointment. You must first arrange your initial appointment prior to completing this pre-registration process by calling our office or by selecting the option to schedule an appointment on this page.
Please complete pre-registration 24 hours prior to your first scheduled appointment. If you have questions or need additional assistance with the pre-registration process, feel free to call us at Encino Office Phone Number 818-788-2155. Having the following will be helpful while completing your pre-registration form:
- Your insurance card
- Your Employment Information or College Information if applicable
Finer Smiles Dental is committed to your safety. Our pre-registration process is secure and your personal information is protected. We recognize the confidential nature of the information you submit online. For this reason, you will be transferred to a secure Patient Portal to complete your pre-registration.
If you prefer to fill out paper copies of our forms, please click the links below to download, print, and completely fill out the forms.
- Patient Information
- Notice of Privacy Practices
- Acknowledgement of Receipt of Notice of Privacy Practices
- Financial Agreement
Bring the completed forms with you on your initial appointment.
Finer Smiles Dental follows federal guidelines that help protect every patient’s health information by limiting the amount of information provided to the public without patient authorization. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that is designed to ensure the portability of health insurance for individuals from one job to another and protect patient health information. Protected health information is any health information that can be used to identify a patient, describe the health-care services provided to the patient, or show information about the payments for those services. It includes all medical records and other information which identifies the patient (such as demographics, medical reports or financial records) in any form (electronic, paper or spoken).
You will receive a copy of the notice outlining HIPAA Privacy when you come in for your appointment.