Harder Dental Corporation
Drs. Gendreau and Harder • (866) 408-1306
Home
About Us
Information
Care Credit Application
Care Credit Information
Newsletter
Patient Education
FAQ
Financial
Location
Contact Us
Useful Links


Information


Office FAX:   (949) 502-8743

Office E-mail:  contact@harderdental.com


PATIENT FORMS
:    Select from the list below for the forms or documents you wish to read or complete before your initial visit.  We require that you complete the forms listed below before your first appointment.  Please arrive 30 minutes early if you plan to complete the forms at our office.

PATIENTS WITH DENTAL INSURANCE:  If you wish for us to bill your insurance company and have your benefits payable directly to our office, you must provide us your dental insurance information (card) to verify your eligibility and benefit provisions before your first scheduled appointment.   Otherwise, you will be responsible to make full payment for services rendered and we will submit the insurance claim on your behalf to have the benefit payments sent directly to you.

MAP & DIRECTIONS TO OUR OFFICE:     Select the "Location" button (to the left) for a map on the Yahoo map system as well as written  directions from all areas of Orange County.

 

 

New Patient Information

Patient Information Form Health Questionnaire Form Financial Policy Form HIPAA and Dental Material Fact Acknowledgment
Privacy Policy Statement Care Credit Application Care Credit Information Dental Materials Facts Sheet
Oral Cancer Screening Consent