New Patient Intake Form
Thank you for reaching out to us!
In order to best help you, please look at our website, then complete our patient intake form below.
Upon your initial visit that consists of at minimum a Comprehensive Examination (fee of $264), we will better be able to determine the type of treatment that may best suit you. IF your symptoms show that you definitely have dental, oral, airway or TMJ issues, we may also recommend an onsite 3D CBCT: a 3D radiograph showing your mouth, joints, airways and neck.
Remember, we treat dental and oral conditions that may have medical symptoms downstream!
Following this initial visit, you will be asked to return for a very thorough Consultation. This is when we will go over in detail your options and the order in which to proceed with your care.
If you need information regarding your Dental insurance, please note that we are a freedom of choice practice, therefore we are an Out of Network Provider. Some of our patients have insurance plans that have Out of Network benefits available. If that is your case and you’d like to utilize your insurance, I suggest you contact your insurance company to see if your particular plan has any out of network benefits available.
Be well!
Need Dental Services?
Call: (321) 777-2797
Hour of Operations
Mon – Thurs 9AM – 5PM
What Our Patients Are Saying
Real stories from patients who discovered how life-changing Health Connections Dentistry holistic dentistry can be.









