DENTIST MANCHESTER CT--Carol Skerpan-COMPLETE DENTISTRY STUDIO

Complete Dentistry

                 studio

  Carol Lee Skerpan, D.M.D.             253 East Center Street    Manchester, Connecticut
06040

It would be a privilege to welcome you into our special family of patients!

PHONE MAP

860-649-4435

  Flexible-Hours--Monday thru' Saturday
on-site parking and on the bus-line

Please be patient with the answering-service--
Leave two telephone numbers and best times to reach you.
    Thank you!

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FOR WRITTEN-DIRECTIONS:
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WRITTEN DIRECTIONS

Contact Form-New Patient Form

* Indicates required field

Name *

First

Last

First Contact Phone Number--- *

Second Contact Phone Number---(e.g., work, landline, friend, other) *

WHO Referred you to this Office?--or HOW did you Find out about Us? *

Enter Best Day & Time to Reach YOU *

Please enter anything else we should know upon calling you: *

By Clicking To Submit I have understood and agreed that the above information will be forwarded to this office by email and not a secure messaging system. This form should
not be used to transmit private health information. This office disclaims all warranties with respect to the privacy and confidentiality of any information submitted through this form.

CLICK TO SUBMIT

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A WELCOME

DR SKERPAN-MISSION-VIDEO

TOOTHSOME TALK---BLOG

FUZZLES-THE-MUZZLE SAGA

BEYOND TEETH & GUMS

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OFFICE BROCHURE

w e b site by--c l s k e r p a n

© Copyright 2022. All Rights Reserved by Carol Lee Skerpan, DMD
© Images in this website are protected by copyright & may not be downloaded,
republished, retransmitted, reproduced or otherwise used as a stand-alone file.

COVID-19 Times
'Welcome Back Letter' for Our Patients
What Should You Expect at Our Dental Office?

COVID-19 Times
Pre-Appointment Compliance Steps
'Pre-Appointment Update Form'

Within 24 hours of your visit the office will call you for a pre-appointment screening & any update of scheduled time.
The 'Pre-Appointment Update Form' below must be SUBMITTED BEFORE the pre-appointment call.
The benefit information in the form below must be completed for benefit submission. The Benefit-Card must also be presented at the office.

Preparing an appointment setup now is more labor intensive and requires allotting more time for you. Therefore, let the office know more than 72 HOURS before the appointment if you think you will need to change it---NOT ON the day of the pre-appointment screening call and NOT AT the pre-appointment screening call!
If you are not feeling well it is expected that you reschedule your appointment. If you have a cough, fever or flu-like symptoms you will not be allowed in the office and you will be rescheduled.
Please arrive on time and alone in the office for your appointment. We ask that anyone with you remain outside.
Please limit personal items to a minimum or leave them in the car.
Patients are to clean & brush their teeth prior to their arrival.
We ask that you use the bathroom as little as possible, and there will be no tooth-brushing allowed in the bathroom!
We ask that you bring your mask to the office--and wear it throughout the office except when in the treatment chair!

ALL changes have been made to protect ALL involved--to keep ALL patients, the office & doctor as safe as possible!
It is expected that everyone will responsibly comply and follow these protocols.
Non-compliant and dis-respectful behavior will not be tolerated, risking discontinuation of the visit.

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   **** Office assistance or calls regarding incorrectly submitted benefit information or for any compliance,
are subject to non-covered ADA Code D9992: Dental Case Management-Care Coordination.
Therefore---be responsible for submitting proper & accurate information in the first place!
  CALL your BENEFIT AGENCY to CHECK your INFORMATION BEFORE SUBMITTING!!