Welcome To Our Dental Practice

 Welcome to our website! We are looking  forward to meeting you and serving you. Please feel free to contact us  for any questions or download our forms below. For new patients with  insurance, please bring all dental insurance information with you. Thank  you. 

New Paperwork 

Please Select the following patient form,  download, print, complete, and either bring in to our office the day of  your appointment or e-mail us a copy on our HIPAA compliant E-mail  address. All new patients who do not download and complete prior to the  first visit are required to arrive 15 minutes early to their appointment  for paperwork completion. Thank you! We are happy to help you! 

Patient Paperwork (Download)

Please complete and sign all pages. Feel free to download and return either paper copy or email. Thank you!

Childrens Form (pdf)


Adult Form (pdf)


No Insurance? No Problem!!

Want to save money for your dental treatment? No insurance or limited finances? No problem!! We have options for you! Sign up for our dental membership options to make dentistry affordable for you and your family. 

(processing time of up to 1 week after applying)

COVID-19 Screening and Consent Forms

Consent for Treatment (pdf)


COVID Risk form (pdf)


COVID Screening Form (pdf)


Payment and Finance Options

 At Valentine Dental Care, we know the  importance of regular dental treatment for overall health and wellness.  Offering quality dental care with premier products at a price that you  and your entire family can afford is also important. For this reason, we  offer a variety of payment options to help you fit the dental care you  need into your dental budget. For your convenience, we gladly accept,  cash, check, Care Credit, Discover, VISA, or MasterCard for payment of all fees  and treatment. (No American Express).

 Payment at 1st Appointment Option: Payment  in full is preferred when services are rendered, unless prior  arrangements (one of the above options) have been made. No accounting  courtesy will be extended for those choosing this option. Additional  details provided in office. Come in and see what we can do for you.  

 Term Loan Option: We offer, upon approval,  low-interest loans up to 6 months through Care Credit many times with no  down payment, no annual fee, and no prepayment penalty. We can complete  your application online for you and have a decision in minutes. If you  prefer, you can follow the links below to complete your application  process and get immediate determination results, all from the privacy of  your own home.

Apply Now Online by clicking  "Care Credit application" below. 

Our Dental Insurance Responsibility

 Valentine Dental Care is proud to be an  unrestricted insurance provider, meaning that no matter what insurance  plan you have, we will help you maximize your insurance benefits. Part  of your first visit with our office is review treatment needed and how  to use your insurance benefits efficiently. Most insurance fee coverage  can be provided as an estimate. Our relationship is with you and not  your insurance company.

We accept many dental insurance policies  including Delta Dental of Michigan,  FEP Blue (not Blue Cross),  MetLife, and others. It is your responsibility to contact your insurance provider if you are looking to stay "in network".  If you have dental  insurance, we will file your claim as a courtesy. Despite this fact, no  insurance plan covers everything, so we have a payment plans available  through Care Credit to assist you in achieving your dental health goals.  Our job is to be your dental consultants and provide you options that  will allow you to reach your dental health goals. The treatment you  receive is your choice and it s your responsibility to know your policy.  We are happy to assist you in accomplishing your goals and answer your  questions as best we can. Please remember that is is your responsibility to know your policy, limitations, and coverage. For any detailed questions please contact your Human Resources Manager through your employer.