Patient Toolkit

Everything you need located in one spot for your convenience.

  • New Patient Forms >>
    If you are a new patient, please fill out the form linked above and submit prior to your first appointment or download the form here.
  • Request Records >>
    Complete this form to request a release of your personal records.
  • Care Credit >>
    Take control of the health of your mouth. With the CareCredit healthcare credit card you can benefit from special dental financing options.
  • Proceed >>
    Pre-qualification in minutes without affecting your credit score.
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Important Information 

Appointments & Cancellation Policy
Your appointment time is scheduled exclusively for you. If this time becomes inconvenient, we will gladly change it. In this instance we require a 24-hour (1 business day) advance notice, otherwise your account will be charged a $35 fee. This allows us time to schedule another patient who may be in urgent need of care. We strive to accommodate the scheduling needs of our patients, and we ask that you arrive promptly for your appointment and we will make every effort to keep your schedule on time.

Fees & Payment
For your convenience, we accept American Express, Visa, MasterCard, Discover, Proceed and Care Credit. Most insurance companies pay only a portion of your bill. The non-covered charges, co-insurance, and deductible amounts are due the day of your procedure.

Insurance
Our practice accepts most major dental insurance programs. As a courtesy to our patients, we complete insurance forms at our expense. Insurance coverage varies and rarely pays 100%. If you have questions about your coverage, please contact your insurance carrier or your employer.

Accepted Insurance Companies
Ameritas, Blue Cross Blue Shield, Cigna, Delta Dental, MetLife, Principal, and United Concordia.

Floss Discounted In-Office Dental Savings Plan

For an annual fee members receive: two cleanings, two dental exams by the doctor, one set of four Bitewing films. Read more.

Dr. Villafane & Kelly Villafane, MS, L-CCC-SLP, COM

Floss Family Dental & Surgical Center

Dr. Justin Villafane leads a practice that provides general and restorative dentistry for the entire family, in addition to treatments for:

  • Sleep Apnea 
  • Tongue- and Lip-Tie 
  • Temporomandibular Joint Disorder (TMD)

As needed, Dr. Villafane can provide these treatments in conjunction with Kelly Villafane, MS, L-CCC-SLP, COM and Link to Communication. To request your consultation, write to us or call (402) 484-5760.

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