New Patients

Thank you for trusting Jackson Pediatric Dentistry for your dental needs! At your child’s first appointment, a hygienist will take any necessary x-rays, and one of our doctors will complete a dental exam and consult with you regarding any treatment needs your child may have. We will then schedule a follow-up appointment if treatment is needed.

Upon registering your child over the phone with one of our receptionists, we will e-mail or text paperwork to you; this paperwork must only be filled out by a parent or legal guardian. (If you are the child’s legal guardian, you must bring legal documentation on your first visit.) Please complete this paperwork. The link is also below.

Our office participates with Delta Dental, Healthy Kids Dental, and MiChild; other carriers will be billed for you. We accept cash, check, Visa, MasterCard, Discover, and CareCredit. Please bring a copy of your dental insurance with you to the first visit.

Payment is due at time of service.

If you need to cancel your child’s appointment, please give us 48 hours notice whenever possible. If your child misses their first appointment, we may not schedule your child for 6 months, except for emergency treatment. We reserve the right to charge for any missed appointments.

 If you have any questions prior to the appointment, please call us.

New Patient Form