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Peter J. Bridgett, DDS John E. Wilkes, DDS Lana W. McDermott, Authorization for Release of Information Patient Name:___DOB:___ Address:___ Phone #:___I hereby authorize (current dentist/office)___to
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Contact West Side Dental Home to schedule an appointment.
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Fill out any necessary paperwork provided by the dental office.
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Provide your insurance information if applicable.
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Arrive on time for your appointment and be prepared to discuss any dental concerns with the dentist.
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Follow any post-appointment instructions given by the dentist for proper oral care.

Who needs west side dental home?

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Anyone in need of dental care and services can benefit from West Side Dental Home.
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This includes individuals looking for routine check-ups, dental cleanings, fillings, root canals, extractions, cosmetic procedures, and more.
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West Side Dental Home is a dental care facility offering comprehensive dental services and treatments to patients in the West Side area.
Typically, dental care providers and facilities within the designated West Side area may be required to file documentation relating to their services, patient records, and billing information.
To fill out the West Side Dental Home documentation, you will need to gather patient information, treatment details, and billing information, and then complete the provided forms accurately before submission.
The purpose of West Side Dental Home is to provide accessible dental care services to the local community, ensuring that residents have available resources for maintaining oral health.
Information that must be reported typically includes patient demographics, services provided, treatment outcomes, billing details, and compliance with healthcare regulations.
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