Patient Information
Resources and information to make your visit as smooth and comfortable as possible
New Patient Forms
Download and complete these forms before your first visit
Patient Registration Form
Personal information, medical history, dental history, and insurance information
Medical History Update
Current medications, allergies, medical conditions, and emergency contact
Consent to Treatment
Treatment consent, financial policy agreement, and privacy acknowledgment
HIPAA Privacy Notice
Privacy practices, rights and responsibilities regarding your health information
Form Submission Options
- • Online: Complete forms through patient portal
- • Email: Scan and email to info@meridianendoindy.com
- • Fax: Fax to (317) [fax number]
- • In Person: Arrive 15 minutes early to complete forms
What to Expect at Your First Visit
Check-in
Arrive 15 minutes early to verify information, present insurance card, and complete any remaining paperwork
Examination
30-45 minute comprehensive review, clinical examination, and digital imaging for accurate diagnosis
Treatment Discussion
Explanation of findings, treatment options, cost estimates, and scheduling of any needed treatment
What to Bring
- • Photo ID
- • Insurance card(s)
- • List of current medications
- • Referral slip from your dentist
Financial Information
Insurance
We accept most major dental insurance plans and file claims as a courtesy to our patients. We work with both in-network and out-of-network benefits.
Insurance Plans Accepted:
- • Delta Dental
- • Cigna
- • MetLife
- • Aetna
- • United Concordia
- • Guardian
Payment Options
We offer flexible payment options to make your care as affordable as possible.
- ✓ Cash, check, and major credit cards accepted
- ✓ Payment plans available through CareCredit
- ✓ Payment due at time of service
- ✓ Detailed estimates provided before treatment
Office Policies
Cancellation Policy
We require 24-hour notice for appointment cancellations. Late cancellations may be subject to a fee. We understand emergencies occur and will work with you when possible.
Late Arrival Policy
Please arrive 15 minutes early for your first appointment. For subsequent visits, arriving a few minutes early allows us to provide you with the full time scheduled for your procedure.
Prescriptions
Prescriptions can be sent electronically to your preferred pharmacy. Please bring your pharmacy information to your appointment. Emergency prescriptions are available when needed.