Doctor Holman Family Dentistry – East Lake County, Florida

We do not double book your appointment time. If you are unable to keep your appointment, PLEASE extend us and your fellow patients the courtesy of giving us a minimum of 24-48 hours notice. We may charge for broken or cancelled appointments if sufficient notice is not given.

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YOUR PERSONAL INFO:

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REQUESTED SERVICES: (Please select all that apply)

	New Patient Examination		Cleaning
	Fillings		Gum Disease Treatment
	Bite Adjustments		Nerve Treatment
	Teeth Bleaching		Crowns
	Cosmetic Dentistry		Extractions
	Partials & Dentures		Other

REQUESTED APPOINTMENT DATE:

FEES & PAYMENTS:

Payment of fees for professional services is expected at the time of the office visit unless previous arrangements have been made.

We accept Mastercard, Visa, Discover and American Express. Financing available through Care Credit

For patients whose dentistry creates a financial hardship, arrangements can be made with a billing company to make payments over 12 months with credit approval. We pay the interest.

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THE MISSION OF OUR OFFICE IS TO CREATE A GROWING DENTAL PRACTICE THAT IS COMFORTABLE, CARING, AND FAMILY ORIENTED WITH EMPHASIS ON TOTAL QUALITY CARE, WHERE WE LOVINGLY EDUCATE AND TREAT PATIENTS IN A MANNER THAT GLORIFIES GOD IN ALL WE DO, SAY AND THINK

We have a 24 hour answering machine which will provide you with phone numbers and emergency assistance on weekends and after normal office hours!

Ronald E. Holman, DDS, P.A.. :: 25520 State Rd. 46 :: Sorrento, FL 32776 Office Phone: 352.735.2211 :: E-mail Office Hours: 8:00 - 4:30 Mon. - Wed., 8:00 - 3:00 Thurs. :: Closed on Friday Closed Daily 12:00 - 1:30 for Lunch

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