Helpful Patient Information

NEW PATIENT FORMS
We can’t wait to meet you – so let’s get started!

Prior to seeing each new orthodontic patient, we need to gather a little information. Here you will find the forms we need for your upcoming appointment. In order to save time at your appointment, please fill out our online formst! Alternatively, you may fill this out at our office; however, please arrive at least 15 minutes prior to your appointment to give yourself time to fill them out.

We value our patients’ privacy and would never sell or share your personal information. It is used solely for the purpose of providing you with excellent service, speeding up your visit and assisting with your insurance. See you soon!

Reminders for your first visit:

  • There is no charge for your consultation appointment
  • This appointment takes approximately one hour
  • You can save time by filling out our new patient forms at home
  • Please bring your dental insurance card

NEW PATIENTS:

NEW PATIENT forms

CURRENT PATIENTS:

laser consent form
Existing Patient History Update Form
insurance update form

FINANCE & INSURANCE 

Dr. Dougherty and the smile squad at Dougherty Orthodontics believes everyone deserves a beautiful, healthy smile and that is why we make every effort to offer payment plans that work with the financial needs of each of our patients. Every smile journey begins with a complimentary consultation. At this appointment we will collect digital x-rays, photo images and perform a complete examination. At the end of the visit, we will give you the cost of treatment and our treatment coordinator will be happy to discuss the payment options we offer to help make your treatment as budget-friendly as possible. Although the cost of treatment depends on the patient’s individual orthodontic issues, we want you to know that there are no hidden fees or extra fees that will be added at a later date.

  • We offer flexible interest-free payment plans that are tailored to meet your budget. These consist of a down payment followed by monthly payments during treatment.
  • If you choose our payment plan, monthly payments are made through electronic auto-debit from your debit or credit card. This is a convenient and efficient way to ensure that your payment is received on time, every time. This service is free for our patients.
  • For your convenience, we accept payment by VISA, MASTERCARD, and DISCOVER.
  • If full payment is made at the onset of treatment, we will offer a fee discount. (If you have insurance, we will offer a discount for payment of your portion of the fee that will not be covered by insurance.)
  • We offer a Family Care Program that provides a fee reduction for each additional family member who begins treatment at Dougherty Orthodontics.
  • The late fee for a missed payment is $25.00.
  • In cases of serious delinquency, treatment will be discontinued, although we will make every effort to accommodate patients with temporary difficulties.

We accept most insurance plans. If you provide us with your insurance plan information before you come in for your consultation, we will call your insurance company to find out your specific benefits. The amount that your insurance covers will be deducted from the total treatment fee. As a service to you, we will take care of all the necessary insurance paperwork on your behalf.

WHAT TO EXPECT
Your step-by-step guide to your first visit:

STEP 1

Your experience starts with
a phone call.

At Dougherty Orthodontics we will call you the day before your first appointment to help prepare you for your visit. We will also send you a welcome packet to give you an introduction to our office with forms to help us get to know you better. Your first visit, or the “Consultation Appointment,” will take approximately one hour.

STEP 2

We can’t wait
to meet you!

Arriving for your visit, you’ll be welcomed by our friendly staff. After we show you how to check in on the front computer, please relax in the lobby with magazines, television, Wi-Fi, and our hospitality bar.

STEP 3

Take a tour of
Dougherty Orthodontics.

Once we’ve gotten all your information, our Treatment Coordinator will promptly come out to the lobby to greet you. She will be excited to take you on a tour of Dougherty Orthodontics. This is a great opportunity to see where you will be spending your time at each visit. This is your opportunity to start asking as many questions as you’d like! We’d love to show you our digital x-ray equipment, paperless office system, and state-of-the-art sterilization center. You will also see the team and Dr. Dougherty at work in the open clinic area, as well as a glimpse of our current patients, who have already started on their way to a beautiful smile!

STEP 4

Private room
consultation meeting.

Your treatment coordinator will take you to your private consultation room where you will have pictures of your teeth and an x-ray taken, at no cost to you. This is where your treatment coordinator will begin listening to you and understanding the concerns you have with your teeth or smile. We want to customize your treatment to accommodate your lifestyles, preferences, and goals. Feel free to ask your Treatment Coordinator anything you would like to know about braces. We’re here to help!

STEP 5

A comprehensive
orthodontic exam.

Dr. Dougherty will examine your teeth and jaw structure and you will be able to sit and discuss potential treatment options. This important exam will address your orthodontic needs to determine if this is the proper time to begin treatment. Again, feel free to ask questions!

STEP 6

Stay informed and educated
about your treatment.

If it is time for you to move forward with treatment, our Treatment Coordinator will be happy to discuss your finances and answer any insurance questions you might have. Our interest-free financing options make treatment affordable to everyone. We want you to be informed and educated about your treatment. Here is a list of what you will have in your hands after your visit:

  • An information packet about braces/treatment at Dougherty Orthodontics
  • Your fee estimate and payment plan options

WE CAN’T WAIT TO MAKE YOU Smile !

SCHEDULE YOUR NEW PATIENT COMPLIMENTARY CONSULTATION TODAY!

OR

START MY VIRTUAL NEW PATIENT SMILE CONSULTATION

READY TO TRANSFORM
YOUR SMILE?

Contact Us!

Kind Words…

“Couldn’t say enough things about Dougherty Orthodontics! Dr. Dougherty is amazing, the staff is friendly and knowledgeable, and the office is always beautiful & fresh. My son looks forward to the drawings they hold. Love this team & thankful for the impact they’ve had on my son’s smile & childhood!”

– Liberty

“My daughter has been coming to Dougherty Orthodontics since she was 8. Not only is the staff friendly and knowledgeable, but the office is very trendy and set up for a phenomenal customer experience. I would never feel this welcome and at home anywhere else. They truly feel like a family!”

– Katie

“We love everyone at this office! They are always so helpful and kind. Love that they are so involved in the community and committed to giving back!!”

– Kim

READ MORE RAVE REVIEWS

Call Us: 636.825.1000
Text Us: 636.825.1000

Monday 8am–5pm
Tuesday 8am–5pm
Wednesday 8am–5pm
Thursday 8am–5pm
Friday: Closed