Smiling young woman using a computer before a dental visit

New Patient Information

Helping your child’s first visit go smoothly

New Patient Forms and Information

Families may complete new patient forms at our office, get help from our staff, or use the online form portal as a convenience.

What We Will Need

  • Your child’s basic health information
  • Dental and medical history
  • Dental insurance information, if applicable
  • Parent or guardian contact information
  • Any details that may help us prepare for your child’s visit

How This Information Is Used

Our team uses this information to understand your child’s health history, dental needs, insurance details, and any concerns you want us to know about.

It helps us provide safer, more personalized care and answer questions during your child’s visit.

Insurance Information for Your Appointment

Papillion Pediatric Dentistry accepts most dental insurance plans. Please bring your child’s dental insurance information to the appointment so our team can help review your benefits and answer any insurance questions.

Our office also accepts Nebraska Medicaid through the three Heritage Health managed care plans:

  • Nebraska Total Care
  • UnitedHealthcare Community Plan of Nebraska
  • Molina Healthcare of Nebraska

If your child receives Nebraska Medicaid through Heritage Health, please bring both cards to the appointment:

  • Medicaid card: The standard Medicaid card sent by the Nebraska Department of Health and Human Services through ACCESSNebraska.
  • Heritage Health plan card: The card from your managed care plan: Nebraska Total Care, UnitedHealthcare Community Plan of Nebraska, or Molina Healthcare of Nebraska.

If you have questions about your child’s coverage, accepted insurance plans, or which cards to bring, please call us before your visit. We are here to help!

Complete Forms at the Office

Families are welcome to complete new patient forms at our office instead of using the online portal.

If you plan to complete forms when you arrive, please come a few minutes early so our staff can help and the forms can be finished before your child’s scheduled appointment time.

Online Form Option

For convenience, new patient health forms may also be completed through a secure, HIPAA-compliant outside portal provided by our dental software vendor.

The portal securely sends the completed information directly to our dental practice software, which helps reduce the need for paper forms.

The portal opens in a new browser page. It is a safe option for submitting new patient information, but it is not required in order to receive care.

Complete New Patient Forms opens in a new page

Need Help With Forms?

If you have trouble opening, reading, or completing the online forms, please call our office at 402.502.1256.

Our staff will gladly help you complete the needed information by phone, in person, or when you arrive for your child’s appointment.