Dr. Monteleone and Dr. Kessler both consider your first appointment with our practice an important educational experience.

A thorough discussion is involved for your specific treatment options. This can provide you with a level of understanding, comfort, and confidence that the work you are about to have performed has been discussed with you in great detail.

After your consultation, we will schedule your surgery appointment unless other arrangements have been made.

Please assist us by providing the following information at the time of your consultation:

• NEW PATIENT FORMS
Please fill out and print our online New Patient Medical History Form to save time before your appointment.

• HIPPA FORM
Please fill out and print our online HIPAA Notice of Privacy Practices.

• REFERRAL FORM
Any and all referral forms from your referring doctor, describing the procedures he / she recommends for you. This is vital to our office communication. There is no time set aside at your consultation to “track it down” at your dentist’s office.

• MEDICATIONS/VITAMINS/SUPPLEMENTS
A full list of all the medications/vitamins/supplements you are currently taking. This is particularly important if you are taking certain cancer medications, blood thinners or have had radiation treatments.

• MEDICAL CONDITIONS
A list of all your medical conditions that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valve, radiation treatment, etc.), past and present.

If you are unsure of your medical conditions, please notify our office before your consultation so that we can contact your family physician to obtain this information.

• INSURANCE
Include all medical and dental insurance information that applies to your account. Providing this information will allow us to obtain insurance coverage for your treatment whenever possible.

As a courtesy to you, we will file your insurance claim on your behalf, thus decreasing the amount of confusing paperwork that will be required of you. Again, there is no time set aside at your consultation to “track it down” at your dentist’s office.

• X-RAYS
Please bring any recent x-rays taken by your general dentist, or request that they be mailed or emailed if they are able to send digital files to our office prior to your appointment.

Please, understand that new x-rays may be required in our office for diagnosis and treatment planning purposes (particularly with implant evaluation, wisdom teeth, pathology and trauma) in addition to the ones already provided by your dentist.

Important

A parent or legal guardian is required during the initial consultation for patients under the age of 18. This is required by law.

Downloadable Forms:

Download our New Patient Form

Complete and mail to:

Monteleone & Kessler
4014 West Estrella Street
Suite B
Tampa, FL 33629