Mesa, AZ. Dentist Patient Information and Forms Robison Dental Group

Dental Insurance We accept assignment of estimated insurance benefits as a courtesy to our patients, provided that you submit a completed original insurance claim or card.

Please note that your dental insurance is a contract between you and the insurance company, not between your dentist and the insurance company.

Our customary fees are a reflection of our commitment to excellence and being the most affordable dental practice in the geographical area.
If for any reason your insurance company fails to pay for services rendered, you are responsible for all payments. All estimated co-payments and deductibles are due when service is rendered.

Current Providers Accepted
City of Mesa
Banner Health Indemnity Plans
All Indemnity Plans
Delta Dental Premier Plan
Boeing Washington Dental Service
** If you do not see your provider listed, contact us to verify their acceptance status.

For Your Convenience, we accept personal checks (with proper I.D.), cash, debit and all major credit cards. As an added courtesy, we also offer a revolving line of credit through a third party, Credit Care (upon approval). This line of credit allows you to start treatment today and spread payments over a comfortable period of time.

Click here to review "Creditcare" online

** There is a twenty dollar ($25.00) returned check fee applied to your account in the event that the bank returns your check.

Missed Appointments. We reserved appointment time especially for you and your specific dental needs. When you cancel on short notice, other patients that needed treatment cannot be seen and the time and money we pay to our staff and for overhead is wasted. Therefore, we ask for your consideration and that you kindly give us a 48-hour notice if you are unable to keep your appointments. If a proper notice is given, the forty-two dollar ($42.00) broken appointment fee will be waived.

Insurance Providers Accepted

Preferred Method of Payment

Patient Medical Forms