I fully understand that I am responsible for paying a treatment deposit before scheduling.
The required deposits are as follows:
- Oral Sedation - $303
- Nasal Versed - $100
- Nitrous - $64
- Anesthetic only - $50
- Frenectomy - $50
I realize that my deposit is non-refundable if I fail to notify the office within 24 hours that my child is not able to attend their scheduled appointment. I understand that if my child is sick and cannot attend his/her scheduled appointment, I must have a note from my child’s pediatrician in order to receive my deposit back. Cancellations made in less than 24 hours during our business week (Monday – Thursday) will result in treatment being scheduled 6 weeks or more after the original appointment.