Patient Forms
A calmer first visit starts before you arrive. Download and complete our new patient paperwork at home so we can spend our time focused on you.
Prepare in Advance
What to Expect
Your first visit with Dr. Jeff Mercando is the beginning of a long-term partnership in your oral health. To make the experience as smooth and unhurried as possible, we ask new patients to fill out a short information packet before arriving. It takes most people less than ten minutes — and it gives our team a head start on understanding your needs.
Patient Information Forms
A single 5-page PDF containing everything we need on your first visit. Compatible with all devices and easy to print at home.
General Patient Information
Tell us about your medical history, current medications, and dental concerns so we can tailor your visit.
Privacy Form (HIPAA)
Acknowledges our privacy practices and how we safeguard your protected health information.
Insurance Authorization
Allows us to verify benefits and bill your insurance carrier directly on your behalf.
Insurance and Financing
Every dental insurance plan is different. Our team will review your benefits and help you understand your estimated coverage and payment options before treatment begins. Payment is still due at the time services are provided. For your convenience, we are happy to submit claims to your insurance company on your behalf and any reimbursement issued by your provider will be sent directly to you.
Financing Options
We understand that investing in your dental health is an important decision. For patients without insurance coverage, or for those planning more comprehensive treatment, we offer flexible financing through CareCredit™. Qualified applicants can apply online and choose from convenient monthly payment options to fit your budget.
Contact Us
Have a question or ready to schedule your next visit? Our friendly team is here to help with appointments, insurance questions, and any dental concerns. Contact us today and take the first step toward a healthier, more confident smile.
Location
1032 N Easton Rd, Suite B
Doylestown, PA 18902
Office
Phone: 215-340-9876
Fax: 215-340-1162
Email Address
mercandodmd@comcast.net