Financial Agreement

Payment Policy:

Full payment is due at the conclusion of the dental appointment.  The deposit placed by the patient will be included in the final anesthesia fee.   Example:  A 2.5 hour appointment will include the initial hour deposit placed by patient who will be responsible for the remaining 1.5 hours of anesthesia time.

Deposit Policy: 

The first hour of anesthesia time will be required for the patient to hold their appointment spot.  This non-refundable deposit is meant to facilitate the pre-surgical preparation performed by your dentist anesthesiologist and will be applied to the final cost of the anesthesia.  The deposit must be received within 24 hours of scheduling the patient to hold the appointment.

We offer payment by phone (262) 455-0016 or an Online Payment option