Patient Info

New Patient Forms
Welcome and thank you for selecting our dental healthcare team. We will strive to provide you with the best possible dental care. To help us meet your dental healthcare needs, please fill out this form completely in ink. If you have any questions or need assistance, please ask us. We will be happy to help.

Health History (pdf file)

Patient Registration (pdf file)

Privacy Notice (pdf file)

Request an Appointment
Set up an initial appointment with Dr. Steven Rasner to discuss your options, needs and concerns. Once you agree upon a treatment plan with Dr. Rasner, you're well on your way to achieving your new smile. Look forward to it, and remember, your smile says it all!

Click Here To Request An Appointment

Links to Websites
American Academy of Cosmetic Dentistry
Academy of General Dentistry
Valley Dental Arts
American Dental Association
Academy of Periodontology
American College of Implantology
International Congress of Oral Implantologists

Financing Information and Options
Our financial policy allows us to provide you with the best treatment available and does not limit your health to just what your plan covers. We will be happy to submit your insurance paperwork for you at the time of treatment. We offer several payment options for your convenience. We accept cash, as well as all of the major credit cards. We also offer payment plans with little or no financing for more extensive dental procedures. If you have any questions about your insurance, please feel free to call for more information.

We Offer Care Credit and Unicorn Financial Services

Michele A. Cortelyou:  Office Administrator
Michele began her career in dentistry with us in 1980, and has been here ever since we are proud to admit. She is in charge of financial treatment planning, scheduling of patient care and public relations. She particularly enjoys seeing fearful patients become trusting patients, as well as those who receive a smile transformation and become overjoyed with their beautiful smile due to the chairside manner and skill of Dr. Rasner. Michele always strives to go the extra mile to ensure patient satisfaction. She attended the American Institute of Banking and Harkum Jr. College, where she received her CDA in dental assisting. She also accompanied Dr. Rasner over the past years with his Realizing the Dream program as a consultant in dental practice management. Michele has three children, Joel, Lauren and Kevin.