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(248) 658-0878 Request Appointment Bill Pay Patient Forms
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Patient Forms

little girl sitting at dentist chair smiling at her dentist

Once you have confirmed your child’s procedure appointment, you can expedite your registration process by downloading the necessary forms provided below. These forms should be completed and brought along on the day of your child’s procedure.

Appointments are carefully scheduled to ensure that each patient receives the appropriate attention from our physicians and staff. Timely arrival for your scheduled appointment is crucial.

As a courtesy reminder, Royal Oak Surgical Center reaches out to confirm appointments 24-48 hours in advance, aiding patients in remembering their scheduled times.

Should your schedule unexpectedly change, and you find yourself unable to make your appointment, please inform us promptly to allow us to accommodate another patient. We kindly request a minimum of 24 hours' notice.

Failure to cancel or reschedule an appointment with at least 24 hours' notice may result in a $50 no-show and late cancellation fee, which will be charged directly to your account. This fee is non-reimbursable by insurance. After two consecutive instances of no-shows or late cancellations, patients will be required to consult their referring physician before rescheduling.

Patients with outstanding no-show or late cancellation fees must settle their balances before scheduling their next appointment.

Forms

  • History and Physical
  • Pre-Operative Checklist
  • Post-Operative Checklist

Pediatric Dental Surgery in Royal Oak, MI

Thank you for choosing Royal Oak Surgical Center for your child’s surgical dental procedure. If you have any inquiries or need further assistance, please do not hesitate to reach out to us at (248) 658-0878. We are here to help.

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Insurance Information

We accept most major insurance plans. For more information regarding the insurance we accept, please contact the office.

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Royal Oak Surgical Center offers pediatric dental services in Royal Oak, MI. Common procedures include General Anesthesia, Dental Fillings, Dental Crowns, Tooth Extractions, and Special Needs Dentistry.