Forms & Financing

Medical patient history

New Patient Forms

Save time and fill out your forms online! Submit your forms through our website or print them out and bring them completed to your first visit. With the information provided, Dr. Jah and the rest of our team can better assess your needs and ensure a more seamless first-time visit at Evergreen Dental Co. We can’t wait to meet you!

Evergreen Dental Co. front office

Accepted Insurances

We are committed to making dental care accessible to patients throughout the Greensboro, Colfax, Summerfield, and Oak Ridge areas. That’s why we are in-network Delta Dental Premier. Don't have Delta Dental Premier? Call our office at (336) 323-2822 to see how we can maximize your insurance.

dental examination room

Flexible Financing

We want to make sure our patients have the option to finance their treatments, which is why we have partnered with CareCredit to offer a third-party financing option for any budget. A great, flexible alternative to dental insurance, CareCredit is a trusted lender that works with over 200,000 providers nationwide. CareCredit can help you create financing plans for all of your dental needs, even elective and cosmetic treatments!

membership plan with Kleer

kleer logo

Frequently Asked Questions

Empowering Our Patients With Knowledge

How Can I Find Out My Dental Insurance Benefits?

While you can contact your insurance carrier to find out your benefits, you can also speak with a member of our team to find out more, including the plans that are in-network.

I don't want to put that much into a tooth, can I just have it pulled?

While extracting a tooth may be an option, it can create a domino effect as it relates to the rest of your teeth and oral health. This is especially true if we are not looking to replace the tooth or do not want to put stress on the rest of your teeth to work overtime.

"I love giving patients a reason to smile while focusing on education and comprehensive care."
– Dr. Tariq Jah