Forms | Best Dentist Gloucester MA

How to Use Our Forms:

Click the button below each form to download or print. You can either print the form and fill it out by hand, or fill it out on your device and download and email it. If you complete your form digitally, fill out the form, then click the print button in the upper right-hand corner of your screen, select “Save as PDF” and email the document to info@Lipkowitzdental.com.

New Patient Form

Health History Form

Dental Questionnaire

Dental Consent Form

Insurance

Currently, we are in-network providers for:

Dental Blue from Blue Cross
Delta Dental Premier
Delta Dental PPO plus Premier
We also accept CareCredit and provide all required documentation to qualify dental expenditures out of your FSA (Flexible Spending Account).

For all other insurances, we expect payment from you at the time of your visit and we will submit all claims on your behalf for reimbursement directly to you.