Call:314.961.3244
Patient Paperwork

To help save time at your appointment, we have provided a Health History forms link below to allow you to fill out your paperwork electronically. We appreciate you doing this before your appointment. Thank you!

X-rays:  If your dentist has taken x-rays, please request them to forward your x-rays to our office.  If the x-rays were taken with "digital" technology, they can E-mail your x-rays to our office at: office@KurtDDS.com
Please have them include the dates the x-rays were taken.

If they are not "digital", please have them mail copies to our office at:
Kurt A. Weisenfels, D.D.S., P.C.
20 W. Lockwood Ave.
St. Louis, MO 63119

If there is not enough time, please pick them up and bring them to our office.  If additional films are necessary or we are unable to read the x-rays your previous dentist has taken, they can be taken at our facility.

We appreciate receiving your x-rays before you arrive for your appointment.  Thank you!

Insurance on Assignment:  We will file your primary insurance as a service to you and will do our very best to maximize your benefits.  We accept assignments of benefits on most insurance policies to lower your immediate "out of pocket" expense.  Please understand that dental insurance is a contract between the patient and insurance carrier...not between the dentist and the insurance company.  The patient is always the responsible party regarding dental fee.

Appointment Reminders: We will try to give you a complimentary reminder call before your next appointment,  but sometimes glitches in technology prevent this from happening. In addition to the phone call reminder, we send out e-mail reminders and text messages prior to your appointment. The best way to ensure your appointment is to mark it on your calendar.

   Health History forms    (Please "click on " Health History Forms to fill out paperwork)

IMPORTANT NOTE: 
        
Please read the forms below completely. We will ask you to sign them at your next appointment.

  HIPAA Privacy Act

  Our Office Policy

  Dental Insurance Consent


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