Request Request Appointment Forms Download Our Forms Like Us Like us on Facebook Reviews Read Our Reviews Portal Visit The ADA Portal Call Give us a Call Map View our Map

New Patient Information

Welcome to Galleria Dentistry! Our practice is always happy to accept new patients from Naples and the surrounding areas in order to give them the beautiful, healthy smiles they deserve. If you’re thinking about coming to see us for the first time, please take a moment to read through the information below. Afterward, if you have any questions, please go ahead and give us a call! We can’t wait to meet you and show you the best that dentistry has to offer.

Your First Visit

After being greeted by our friendly front desk team, you’ll be escorted to your treatment room where a member of our hygiene team will perform a brief oral exam. After that, you’ll get to meet your dentist, who will spend a little time getting to know you before completing a more thorough exam. After that, they will go over their observations with you and discuss any additional treatments you might need.

Patient Forms

For your convenience, we’re happy to now offer the forms you’ll need to fill out before your initial appointment online. You can fill them out and submit them to us electronically, or you’re welcome to print them out, fill in the pertinent information, and bring them with you. If you choose the latter, please make sure to arrive around 15 minutes before your appointment starts so that our front desk team has time to input the information into our system.

If you’re using a regular PC, please follow the link below to fill out your form online. Having Adobe Reader downloaded is necessary for this option.

Fill Out Forms Online

If you’re using an Apple product or you don’t want to submit your info online, please download, print, fill out our forms and bring them with you to your appointment.

Patient Information Medical History Financial Policy HIPAA Consent to Release Dental Records

While a review of your medical history may not seem that important, this information is critical to safely provide care to you. Medications and previous treatments/surgeries can affect what services we recommend. Hip and knee replacements often require a doctor’s release and premedication before you attend a visit with us. Please make a list of the current medications you’re taking as well, and inform us of any changes at the earliest possible time. In addition to medication and patient forms, please bring the following to your first appointment:

  • Photo ID Card
  • Insurance Card (if applicable)

Insurance Accepted

Our practice is happy to accept all insurance plans that allow you to choose your dental care provider. We’ll even file the claim for you to make things nice and easy. However, we are not in network with any dental insurance providers. Often, you’ll be asked to pay for your treatment up front so you can be reimbursed by your insurance provider later, so please come prepared to your appointment if this is the case. To learn more about how we can use your particular plan to help you save on your care, please contact us today.

Financing Available

To help break up the out-of-pocket cost of your care, we will accept a payment plan from CareCredit. With CareCredit, you can qualify for low-to-no interest financing that has no hidden fees, charges, or penalties. They have plans that are able to work with any budget, and to find one that is right for you, you can click on the link below. Please let us know if you have any questions about your financing options.

Apply for CareCredit

ADA Patient Smart Portal

Are you interested in learning more about our available dental services, common problems and pitfalls that can affect healthy smiles, and tips for how to improve your oral hygiene at home? The ADA Patient Smart Portal offers easy access to all of this valuable information and much more – just click the link below to start learning. You are also always welcome to ask our team at Galleria Dentistry about questions or concerns, should you have them.

Access The Patient Smart Portal