Forms & Financing

The necessary paperwork

New Patient Forms

Prior to your child’s first visit, we’ll send you new patient paperwork for you to fill out ahead of time. If you don't get a chance to, it no problem you can fill it out at the office as well. Just bring your photo ID and a copy of your insurance card.

All About Insurance

Accepted Plans

We proudly accept a wide variety of PPO dental insurance plans, including:

  • Aetna
  • Ameritas
  • Beam
  • Carefirst
  • Delta Dental
  • Florida Blue Dental
  • Florida Combined Life
  • Freedom Life Insurance
  • Guardian
  • Cigna
  • Humana
  • Lincoln Financial
  • Metlife
  • Oscar
  • Principal
  • Renaissance
  • Solstice
  • Sunlife
  • Sure Bridge
  • United Concordia
  • United Health Care
  • US Health Group

This is not a complete list of our in-network and out-of-network plans. If you have a question about insurance coverage, our office staff is happy to talk you through different payment options at any time.

Other payment options

Healthcare financing

We strive to make dental care affordable for all members of our community, which is why we also offer payment options for patients without dental insurance through two different healthcare lenders: CareCredit and Sunbit. Sunbit offers no hard credit check and 6-72 monthly payment plans. If you have any questions about other payment options, our office staff will be happy to answer them for you.

sunbit application

$199 intro Offer for 3 and older

New Patient Special

If it’s your child is 3 and over and is their first time at Pediatric Dentistry of Horizon West, be sure to take advantage of our $199 new patient special. They will receive a comprehensive dental exam, teeth cleaning, fluoride treatment, all necessary x-rays including a panoramic film if recommended, and Dr. Azer will help you determine the best plan for your child’s future dental care

Learn More

$99 Intro Offer for under 3

New Patient Special

If it’s your child is under 3 and is their first time at Pediatric Dentistry of Horizon West, be sure to take advantage of our $99 new patient special. They receive a dental exam, teeth cleaning, x-rays if needed, and Dr. Azer will help you determine the best plan for your child’s future dental care

Learn More

No insurance? No problem!

Membership Plan

See how simple and affordable great oral health can be! For our patients who don’t have or choose not to use insurance, we recommend our in-house membership plan to simplify costs, cover your preventive care, and save money on a variety of treatments and procedures.

Plans for everyone

affordable annual fee

comprehensive care

no insurance company hassle

Baby & Toddler

0-2 years old

$25/Month

$99 Lifetime Activation Fee

  • 2 cleanings
  • 2 routine exams
  • diagnostic x-rays
  • 15% off treatment
  • Fluoride Treatment
  • $99 Lifetime Activation Fee includes first month
  • savings in total: $344

Child

3-12 years old

$35/Month

$99 Lifetime Activation Fee

  • 2 cleanings
  • 2 routine exams
  • diagnostic x-rays
  • 15% off treatment
  • Fluoride Treatment
  • $99 Lifetime Activation Fee includes first month
  • savings in total: $437

Teen

13 years old and up

$37/Month

$99 Lifetime Activation Fee

  • 2 cleanings
  • 2 routine exams
  • diagnostic x-rays
  • 15% off treatment
  • Fluoride Treatment
  • $99 Lifetime Activation Fee includes first month
  • savings in total: $492
call now (407) 554-4222

Give your child’s smile a head start

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