New Patients
​We would like to thank you for your consideration and selection of Dr. Chapman as your trusted dentist for your cosmetic and general dental needs. Given the importance of your first visit and in order to make the process easy, we encourage you to complete the patient forms in advance of your appointment so to save you time. For your convenience, contact information and directions to our office are also provided below. We look forward to seeing you in our office.
NEW PATIENT FORMS
In order to expedite the processing of your information and facilitate your first visit, we encourage you to print and fill out the forms listed below and bring them with you for your first visit:
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Patient Information (Form 1 - Two Pages) - Please print and complete both pages.
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Dental & Medical History (Form 2 - Two Pages) - Please print and complete both pages.
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HIPPA (Form 3 - Two Pages)
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Office Policy (Form 4 - One Page)
INSURANCE, BILLING AND PAYMENT
Our goal is to provide quality treatment that is accessible and affordable for our new and existing patients, whether you are covered by dental health insurance or not. As such, we accept a variety of payments including checks as well as credit and debit cards. We also accept many different insurance plans and file-claims. We offer CareCredit and third-party payment plans and options for patients without insurance. Please feel free to call our office for more information or with questions about insurance coverage.
Insurance Plans We Accept:
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​ ​Aetna PPO
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​ Cigna PPO
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Delta Dental PPO
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Guardian PPO
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Metlife
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United Concordia
MAPS, DIRECTIONS, CONTACT INFORMATION
Our hours of operation as well as a map of our location are provided below. You could also use the map tool for door-to-door directions to our office, which is easily accessible by Bergen County residents and minutes away from Rockland County. Note that our facility is wheelchair accessible. Please feel free to call us with any questions or comments.
Address: 101 N. Kinderkamack Road, Montvale, NJ 07645 (see map below)
Tel: (201) 307-3323
E-mail: info@chapmanDMD.com