Dear New Patients,

Thank you for choosing Hilltop Dentistry as your primary oral healthcare provider. Quality dental care is our first priority!

Hilltop Dentistry accepts your insurance payment if the following information is provided 2 business days prior to your appointment, when applicable. Please fill out the form below to submit your information to our office.

Is there secondary insurance? If so we need the same information for the secondary policy. Please provide the details as above 2 business days prior to your appointment, so we can verify your coverage before your appointment.

New Patient Form

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