Patient Center - Austin, TX

We Welcome You

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New Patient Information

We appreciate your decision to partner with Council Oak Perio.

We really do view working with our patients like a partnership. After all, without your participation in correct maintenance and oral health techniques, we won’t succeed. Our friendly staff is committed to creating a periodontal experience that is as comfortable and pleasant for you as possible.

New Patient Form
dr bingham Austin TX

Your initial visit provides us a chance to get to know you.

More importantly, this initial visit gives you a chance to know us. When you visit Council Oak Perio for evaluation and treatment, you are not simply a patient…you are family! During your initial visit, our staff will complete an in-depth medical and dental health history. This important information helps us to accurately evaluate your current periodontal health status. Additionally, this allows us to treat you in the safest manner possible.

No treatment is rendered during your initial appointment.

This appointment allows us to gather information, listen to your questions/concerns, and recommend a potential strategy that will improve your oral health.To minimize your wait and respect the time of our other patients, we ask that you provide the following information at your first visit:

Medical History

This may be completed by filling out the following form:
New Patient Form

X-Rays – to accurately diagnose your health, we require current Xrays and/or CT scans.

If your referring dentist has taken Xrays in the last six months, please forward them to us. If you do not have recent images, or if additional imaging is needed for diagnosis and treatment, that’s not a problem; Dr. Bingham will take the necessary imaging.

Our periodontists are available Monday through Thursday to see you.

Please allow 45-60 minutes for your initial visit. We will do our best to schedule your visit as soon as our calendar permits. If you have severe pain or need emergency care, we will do everything we can to see you as soon as possible.

We request that you give us 48-hour notice if you need to cancel an appointment.

This courtesy allows us to reschedule your time for another patient.

NOTE: Patients under 18 years of age must be accompanied by a parent or guardian.

Payment Plans

Council Oak Perio understands that your dental treatment is a significant financial investment. That’s why we’re happy to offer our patients extended payments through CareCredit® and LendingClub.

CareCredit is a credit card exclusive for healthcare services. With CareCredit®, you can get a no interest* payment plan if paid in full within 6 or 12 months on purchases with your CareCredit® card. Unlike regular credit cards, CareCredit® has no teaser rates or application fees and there are no pre-payment penalties. You get special financing with low fixed monthly payments each and every time you use CareCredit®. Use your cash and major credit cards for other expenses and finance your treatment procedure with CareCredit.

Click here for more information about financing your treatment with CareCredit®.

Insurance

Most traditional insurance plans will reimburse you for our services based on your specific plan benefits. Payment for procedures is requested at the time of service and our insurance coordinator will be happy to assist you with filing your dental claims. After receiving your claim, your insurance company will then directly reimburse you based on your particular benefit plan.

Schedule Your Appointment Today!

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