Serving Tyler, TX and the Surrounding Areas903-597-7721
Patient Forms & Financing
Convenient Patient Forms
Your time is precious, and we know there's about a million things you'd rather be doing than sitting in the dentist's office filling out forms. You want to get in and out as quickly as you can. That's why we've made our new patient forms available online. Print them out at home, fill them out at your convenience, and bring them to your first visit.
Click on the forms below to print them out, then call Burnett Dental Care at 903-597-7721 to schedule your appointment. Our office works with most insurance companies on all necessary paperwork. Same-day and walk-in appointments available.
Our goal is to facilitate a way to help you receive the dental treatment you need in a timely manner. For our patients’ convenience, we offer various forms of payment for our services as listed below:
Payment of service rendered at each appointment. We accept cash, check, and most major credit cards.
On charges for $1,000 or more, there is a 5% bookkeeping courtesy discount when paid in full by cash or check. If insurance is involved the insurance company would reimburse the patient for payments of benefits.
We provide a couple of different services for our patients who wish to finance the payments over time. Although we have no direct interest in either of these companies we offer the following information for our patients’ convenience.
CareCredit – Interest-free payment plans for treatment fees from $300 to $25,000
CareCredit – Extended payment plan for treatment fees from $1,000 to $25,000
More time to pay
Convenient fixed, monthly payments
No pre-payment penalty
9.9% interest rate, terms up to 48 months
Call 903-597-7721 for a FREE cosmetic dentistry consultation