Patient Forms, Map and Directions to Rick J. DeRoven, D.D.S.- Walled Lake Office

Your first visit at our office with Dr.Rick DeRoven establishes a the foundation for our relationship with you. During the first visit, we make sure to obtain important background information, including your medical history, and give you time to get to know us. To understand what to expect during your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, office hours, payment policies and more. You can save some time at your first visit by printing out and completing the patient forms in advance of your appointment.

Mission Statement
At Dr. Rick DeRoven's office, our staff works together to ensure comfortable and respectful patient service, while providing the most appropriate dental treatment for each person's individual needs and budget.

To fulfill this mission, we are committed to:

  • Listening to and respecting our patients.
  • Earning and maintaining the trust and confidence of our patients.
  • Exceeding your expectations.
  • Ensuring a respectful, informative, productive and compassionate professional environment.
  • Developing a long term relationship with our patients and staff.


REGARDING OUR FINANCIAL AND APPOINTMENT POLICIES

INSURANCE

Our staff will be happy to bill your insurance carrier. However, your insurance agreement is between you and your insurer- if they fail to pay for any reason, you are responsible for the entire charge.

FINANCIAL

1. All co-payments, deductibles, and non-insurance covered services are due at the time of service. We accept cash, checks, Visa, Mastercard, Discover, and American Express. We also offer CareCredit, a credit card specifically for healthcare.

2. With regard to children and minors, the parent or guardian accompanying the child to the appointment is responsible for payment for services rendered.

3. For our non-insured patients, we offer an in-house fee reduction program. For a small annual fee per family, you may save up to 40% from our usual, customary fee schedule. Please call for details.

4. If you are experiencing financial difficulties, please discuss your situation with our business office staff. We will make every attempt to accomodate your particular situation. Accounts past due over 90 days may be referred to a collection agency.

 

APPOINTMENTS

Your appointment will be confirmed with you by phone 1-2 days prior to your visit. Your appointment time is reserved especially for you. Please be prompt. If you arrive late, your appointment may need to be rescheduled. If you must cancel or change your appointment, please notify us at least 24 hours in advance, so the time may be used for another patient. Failure to do so may result in a missed apointment charge being added to your account. Multiple missed appointments may result in your termination as a patient in our office.

 


Patient Forms
Please print and fill out these forms so we can expedite your first visit:


In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.



What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. Please make sure to provide all medical information, including medications you take and your Dr.'s name. If you have dental insurance, we will need the policy information to help determine your benefits and copay. We will need your identification and social security number for security and privacy regulations.

Minors must be accompanied by parent or guardian.



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