Patient Forms for DHA (Madison, Fitchburg)
Register in advance below to save time at the clinic:
49 N. Walbridge, Madison
Why do you need my insurance information prior to my appointment?
What insurance information do I need to complete the insurance section?
As much information as you have is greatly appreciated. To get an accurate idea of your plan, though, the following information is needed:
- your dental insurance name
- the full name (as your insurance spells it) and date of birth of the subscriber (the person who holds the insurance)
- the subscriber's employer the plan is through
- your member ID number
- the plan's group number
- the insurance's phone number
All of this information is either located on your dental insurance card or in your packet of information sent to you by your insurance company after you enrolled in your plan. If you have questions, feel free to call us or bring your information to us, or call your insurance company to get direct answers.