Patient Resources

Online payment is now available

To pay your bill online on a secure site, visit the payment tab for more details.

Patient Forms, Map and Directions to Columbus Office

Your first visit to Worthington Pediatric Denistry establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can even save some time at your first visit by printing out and completing the patient forms in advance of your appointment.

Mission Statement

Our practice is working together to realize a shared vision of uncompromising excellence in dentistry.

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.

Office Policy

It is our goal to provide a great dental experience for our patients. Please see our office policies below.  

• We request that you show up to your appointment 15 minutes early. If you are 15 minutes late you run the risk of being rescheduled for your appointment.  We can ask if someone is available to take you, but we can’t guarantee that will happen.
• Parent or Guardian is NOT allowed to leave the premises if your child is under age 18.  We MUST always have someone here.
• Parent(s) or legal guardian(s) need to be here for 1^st appointment.  If you’re unable to attend future appointments and someone else brings your child, we need a written letter stating you’re giving permission for treatment on your behalf to the person who brought the patient.
• New Patients-if you No Call / No Show you will be dismissed from our practice.
• After being established at our practice and you have a 2^nd No Call / No Show then you must call to see if we have appointments available for the same day only. After a 3^rd No Call / No Show you will be automatically dismissed from practice.
• You MUST have your INSURANCE CARD for your appointments. If one wasn’t provided to you, you need to contact your HR department or try and go online to get a copy.
• We MUST have social security numbers for you and your child. 
• We ALWAYS need a Driver's License for the guardian. 

Patient Forms

In the link below, you will be able to access our New Patient Form. Please print and complete all the pages, then bring them with you to your appointment. 

New Patient Paperwork

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it:

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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.

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