New patient info...

Please click on the links below to access the Health History Form, Notice of Privacy and Medical Order Request Form, which are all required as a new patient. All forms need to be submitted to prior to the first appointment. The medical order needs to be filled out and signed by a physician, surgeon or dentist.

Please submit all forms to kswansonrdhap@gmail.com.

New Patient Forms

Notice of Privacy Form

Medical Order Request Form

Fees for Service

We deliver the finest care at the most reasonable cost. Payment is expected at the time of the appointment. For your convenience, we accept Visa, Mastercard, check, and cash payments via Venmo, Zelle and PayPal.
Visits to each patient's home are booked in 1-hour blocks to provide sufficient and necessary treatment. Fees are assessed at $175 per visit.

Cancellation Policy

Our goal is to provide quality dental hygiene care in a timely manner. We do understand that illness and emergencies do occur. We ask our patients to give us 24 hours’ notice whenever possible if they cannot keep an appointment. This allows us time to fill our schedule with other patients who may be waiting. We appreciate your understanding and consideration regarding our cancellation and failed appointment policy.

Cancellation or rescheduling of an appointment with 24 hours or more notification will result in no charge.

A failed appointment is an appointment that is cancelled/rescheduled without 24 hours' notice or an appointment where a patient does not show up.

We do allow for one (1) broken appointment as a courtesy.

Any additional failed appointments will be charged a fee of $40 for a hygiene appointment.
After two (2) failed appointments, we may require a deposit of up to 100% that will be applied to your appointment, in order to reserve any further appointments.
After three (3) failed appointments you risk being dismissed from the practice.