Patient Forms, Map and Directions
At Kentlands Family Dentistry we value our patients. Every patient is treated in a caring, empathetic, understanding, honest, and professional manner, and we strive to deliver the highest level of gentle compassionate care that you deserve.
Our professional and compassionate staffs actively pursue continuing education and stay on top of the the latest dental technology. We believe in patient education, and always partner with our patients in making educated decisions about their oral health, treatment options, and choice of dentist . Our multilingual staff brings English, Spanish, Chinese, and Tagalog to a broad range of patients - allowing us to serve a diverse population here in North Potomac, Rockville, and Gaithersburg.
You’ll find all of this important information on our website, including directions to our North Potomac office, service descriptions, patient forms, patient education resources and more.
Mission Statement
We strive to provide our patient a beautiful, happy, and healthy smile that lasts a lifetime!
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Patient Forms
Please print and fill out these forms so we can expedite your first visit:
- New Patient Registration Form
- Financial Policy Form
- Privacy Policy Form
- Request to Release Dental Records (to have dental records sent to our office from your previous dentist)
- Patient Screening Form
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: 
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.
Care Credit
If you're uninsured or would like to learn about reducing the cost of financing your dental treatment, CareCredit may the perfect solution for you. CareCredit offers an easy, interest-free financing option that breaks your balance down into manageable monthly payments. You won't be charged interest as long as you pay the balance in the agreed time period. CareCredit is easy to apply for, and we can help you here at our office or you can easily apply online at the CareCredit website.
Cash/Check Discount
We offer a 10% cash/check discount for patients without insurance. Payment must be made at the time of service.
Accepted Insurance
Dental insurance is often complex and difficult to understand. We want you to feel confident that you are always getting the most out of your coverage, and we're here to help. We work with most PPO plans and will be happy to file your claim on your behalf.
Currently, we work with the following insurance plans:
- Aetna
- Assurant
- Blue Cross Blue Shield
- Carefirst BCBS
- Careington
- Cigna
- Delta
- Dentamax
- Dominion
- GEHA
- Guardian
- Humana
- MetLife
- Maryland Healthy Smiles (for children under 21 only)
- Principle
- United Concordia
- United HealthCare
Please don't ever hesitate to contact us if you have questions about insurance or financing your treatment. We're here to provide you with the guidance you need so that you can get the treatment you deserve.