New Patient Information

Practice Policies

Your first visit to Sullivan Dentistry establishes an important foundation for the ongoing doctor-patient relationship. During your first visit, basic information will be gathered, including your medical history.

Sullivan Dentistry wants to be more than just a room for clinical procedures and policies. To avoid this, an environment where you can relax and take your time to become familiar with the doctors and learn about what makes us leading West Tennessee dental practitioners has been created.

For your convenience, please print and fill out the forms below and bring them to your first visit.

• New Patient Information
• HIPAA compliance form

Sullivan Dentistry Dental Assistance Saving Plan

The Sullivan Dentistry Dental Discount Plan is designed to provide affordability and greater access to quality dental care.

• No yearly maximums
• No deductibles
• No claim forms
• No pre-authorization requirements
• No pre-existing condition limitations
• Immediate eligibility (No waiting periods)
• Free consultations

Click here for the Savings Plan Application Form

Payment Options

Cash, Check, Money Order, Visa, MasterCard, Discover

We also provide financing options through Cherry. Click here to apply and check your approval status.

Insurance Claims and Billing

For patients with dental insurance, we focus on providing care that is best suited to you, not dictated by your insurance provider. While your insurance may help cover some costs, you remain responsible for any outstanding balance. We will provide an estimate for all treatment plans. Please be aware that after your insurance has paid their portion, any remaining balance will be your responsibility.

If you have insurance, we can request a pre-determination to clarify coverage details for major procedures and treatment plans.

How it Works

• At the time of your appointment, you’ll be responsible for paying the estimated patient portion.
• We will submit the claim on your behalf, and the insurance company will pay us directly.
• If the insurance payment differs from the original estimate and there is an outstanding balance, you will be responsible for covering the difference.