Our office, as well as the The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.

We Welcome New Patients

We are honored that you have chosen our office for your child and family. We strive to make each and every visit to our office a fun one. We provide a child-friendly atmosphere with activities and décor to make your child feel comfortable.

 

You can make the first visit to the dentist enjoyable and positive. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as "needle", "shot", "pull", "drill" or "hurt". The office makes a practice of using words that convey the same message, but are pleasant and non-frightening to the child.

 

We invite one parent/guardian to stay with your child during the initial examination.. During future appointments, we enourage you allow your child to accompany our staff through the dental experience. We can usually establish a closer rapport with your child when you are not present. Our purpose is to gain your child's confidence and overcome apprehension. However, if you choose, you are more than welcome to accompany your child to the treatment room. For the safety and privacy of all patients, other children who are not being treated should remain in the reception room with a supervising adult.
 
Please begin by completing the registration form below for each child who will be visiting our office for the first time. Please log in and complete the form and then submit the form electronically. If you prefer, you can print the form and fill it out and bring it to your appointment.


*If you are having trouble submitting forms, try a different browser 

Patient Forms

New Patient Forms

Please fill this out prior to your child’s appointment
Online new patient form

COVID-19 form

We kindly ask you to submit this form no earlier than 48 hours prior to your child’s appointment.
Online COVID-19 form

Online Records Release form

If you wish to transfer your child’s records- although your child may not have an appointment set up please enter an appointment date sometime in the future.

Online Records Release form

Printable New Patient Form

Printable Health History Update

 

INSURANCE AND FINANCIAL SERVICES

We accept most insurance plans. Please call our office and our trained staff can help you understand your plan and benefits. As a courtesy, we will file all claims to your insurance company for any necessary dental treatment your child needs. Our team is always available to answer any questions you have about your dental insurance and we work to help you maximize your benefits

Care Credit

We accept care credit.  CareCredit is different from a regular credit card.

Use it to pay for out-of-pocket expenses not covered by medical insurance, and special financing options are available that you may not be able to get with other cards and Allows you to pay for out of pocket health expenses over time.

Click here to visit care credit website

Request a New Patient Consultation

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CONTACT US

Keystone Pediatric Dentistry 

3591 Reserve Commons Dr

Suite 200

Medina, OH 44256

 

Phone:  330.723.7566

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