Patient Forms

    Home Patient Forms

    Patient Resources

    Building a foundation of trust by treating our patients as special individuals is vital to our success. Our entire team is dedicated to providing you with excellent, personalized care and service to make your visits as comfortable and pleasant as possible.

    To Make A Payment, Click The Button Below

    Payment Options

    For your convenience, we accept cash, personal checks, money orders, and most major credit cards. Payment is expected at the time services are performed.

      dentist Patient Forms  

    We offer a discount on all services over $500.00 when pre-paid or paid in full on day services are rendered.  We also offer a flexible payment plan.  Please see our Financial Coordinator for details.

     

    Dental Insurance

    Potrykus Family Dentistry does not participate in Health Management Organizations; however, we will be happy to file insurance claims for you for reimbursement as long as you are free to choose your own dentist.

     
    An Update on Delta Dental

    Financing Options

    Potrykus Family Dentistry is committed to making your dream smile a reality with flexible payment plans and financing options for all patients. With a single, easy application, we’ll help you find a plan that fits your budget. Plus, we offer free financial consultations to answer your questions and explore the best options for you.

    dentist Patient Forms
    dentist Patient Forms
    dentist Patient Forms
    dentist Patient Forms
    dentist Patient Forms
    dentist Patient Forms

    EAGLE RIVER OFFICE

    Monday – Thursday7:30AM – 4:30PM
    FridayBy Appointment

    THREE LAKES OFFICE

    Tuesday – Wednesday7:30AM – 4:30PM