Patient Information

INITIAL CONSULTATION

Outstanding dental health for a lifetime, or finally having the beautiful smile of your dreams — whatever your goals, our suggestions for your care are based upon sound principles that insure you, our valued patient, achieve the best long-term results.

Your initial appointment enables us to review your medical and dental history, discuss your treatment goals and conduct a comprehensive dental examination. Once we gather all essential information, we will share our findings and provide you with information and options to achieve your goals.

Please provide the following at the time of your initial consultation:

  • Recent x-rays if available
  • A list of medications you are presently taking
  • If you have dental insurance, the necessary completed forms. This will save you time and allow us to help you process any claims. 

IMPORTANT: Patients under 18 must be accompanied by a parent or guardian.

Please alert the office if you have a medical condition that may be of concern, such as a heart murmur, diabetes, high blood pressure, artificial heart valves or joints, rheumatic fever, etc.; or if you are on heart medications, aspirin therapy, anticoagulant therapy, etc.

Forms
Save time by completing necessary forms before your appointment. The forms below require Adobe Acrobat Reader (click for free download). 

     Patient Registration‡
     Important Dental Insurance, Financial and Appointment Information‡ 
     Request Dental Records from your Previous Dentist ‡
     Request Dental Records from Highpoint Dental Medicine ‡ 
* Please complete as required, print, review, sign and bring to your office visit.

X-Rays
If your doctor has taken x-rays, you may request that they forward them to our office or we will call and request them for you. If there is not enough time, please pick them up and bring them to our office. If any additional x-rays are necessary, they can be taken at our office.

Insurance - click here for information.

Please contact us at 215-822-1866 or by e-mail at info@highpointdental.com if you have any questions or to schedule an appointment. 
 

 

 

 

 

 

Highpoint Dental Medicine, located in Chalfont, PA, is the practice of general and cosmetic dentist Dr. Brian Wilk, general dentists Dr. Emily Eilerman, Dr. Richard Titlebaum and Dr. Andrew Berman. Highpoint Dental Medicine is committed to your oral health care, specializing in dental procedures such as dental implants, dental bridges, TMJ treatment and dental restorations, and cosmetic dentistry procedures such as Zoom® and custom tray tooth whitening, cosmetic veneers, cosmetic bonding and Invisalign® (invisible braces). Whether you are new to the area or a long-time resident looking for a new cosmetic, family or pediatric dentist that cares about doing the right thing - we welcome you to Highpoint Dental Medicine. Our state-of-the-art dental office has been serving families throughout Chalfont, New Britain, Doylestown, North Wales, Montgomeryville, Lansdale, Colmar, Hatfield and surrounding areas since 1992. We offer FREE/discount tooth whitening for new patients - or a FREE dental exam. Call our office at 215.822.1866 or e-mail us at info@highpointdental.com for more information about our treatment methods or to make an appointment.