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PATIENT INFORMATION

Excellence in Dentistry

PATIENT INFORMATION

Become a member of our dental family at Arrow Dental Center! Our doctors and their team work with patients of all ages in Monroe, LA and the surrounding areas. Many members of our staff have been with us for over 25 years, and we take pride in the family-like atmosphere our patients can enjoy at our office. Your smile and comfort are always our priorities. Excellence in dentistry—that’s what we strive for every day, and you will notice the difference as soon as you walk in our doors.

Dental Emergency?

For emergency dental care, call us at 318-361-0381 during office hours and we will see you as soon as possible. After hours, call us and we will direct you to the nearest dental emergency center. We’re open on Saturdays!

Proudly Serving Families in Northeast Louisiana & Southern Arkansas

Appointments

We are currently accepting new patients! To schedule an appointment, please call our office at (318) 361-0381. If for any reason you are unable to keep your scheduled appointment time, please call us with 48-hours notice to reschedule, so we can offer that time to another patient.

What to Bring to Your First Appointment

To save time in the office, please bring the following items with you to your first appointment:

  • Insurance Information/Card
  • Photo Identification
  • Any relevant medical records

Patient Forms

Filling out our patient forms before your first appointment will help you save time in the office during your visit. Please click the link below to download and print this paperwork.
Download Patient Form

Insurance

We accept most dental insurance plans. Please familiarize yourself with your insurance plan, paying close attention to your benefit maximums, deductibles and covered percentages. Our knowledgeable, experienced staff will help you completely understand your dental benefits and will prepare all the necessary forms for your benefits. However, we remind you that your specific policy is an agreement between you and your insurance company.

Please know that you are responsible for your total obligation should your insurance benefits result in less coverage than anticipated. We do not render our services on the basis that insurance companies will pay all of our fees. We base our treatment on what is best for you. Your benefits are contracted between your employer and your insurance company.

Payment

Payment is expected at the time services are rendered, unless other arrangements have been made. This includes any copayments or deductibles (amount not covered by your insurance).

For your convenience, our office accepts cash, Visa, MasterCard, & Discover.

For more information about our office policies, or to schedule an appointment, contact us today at (318) 361-0381. Or, click here to make your appointment online!

Arrow Dental Center

Emergency Contact Info

PHONE NUMBER (IF DIFFERENT FROM ABOVE)

EMPLOYER (IF DIFFERENT FROM ABOVE)

PRIMARY DENTAL PLAN

SECONDARY DENTAL PLAN

Although dental personnel primarily treat the area in and around your mouth, your mouth is a part of your entire body. Health problems that you may have, or medication that you may be taking, could have an important interrelationship with the dentistry you will receive. Thank you for answering the following questions.

WOMEN: ARE YOU...

ARE YOU ALLERGIC TO ANY OF THE FOLLOWING?

DO YOU HAVE, OR HAVE YOU HAD, ANY OF THE FOLLOWING?

DENTAL HISTORY FORM

WHAT CONCERNS DO YOU CURRENT HAVE WITH YOUR ORAL HEALTH OR SMILE?

(please check all that apply)

ARE YOU INTERESTED IN LEARNING ABOUT THE FOLLOWING?

(please check all that apply)

FINANCIAL POLICY

Our office is committed to providing you with the best possible care. lf you have dental insurance, we will help you receive your maximum allowable benefits. ln order to do this, we need your full understanding of our financial policy.

Payment for services is due at the time of service unless payment arrangements have been approved in advance. We do not offer in house financing. We accept cash, money orders, Care Credit, and all major credit cards. If you have insurance, we will ESTIMATE to the best of our ability your portion and we will file your insurance for you. Please be prepared to pay your portion at the time services are rendered. If your insurance company does not pay all that we have estimated, you will be responsible for any balance not paid by the insurance. We will gladly discuss your proposed treatment and answer any questions relating to your insurance.

You MUST realize however that:
  1. 1. Your insurance is a contract between you, your employer and the insurance company
  2. 2. Dental insurance does NOT pay 100% of all treatment. It is meant to assist you in covering some of the expense and the remaining balance will be your responsibility.
  3. 3. Please do not ask us to recommend treatment based on what your insurance will pay. We are committed to your dental health and will treat you according to your needs.

We must emphasize that as dental care providers, our relationship is with you and not your insurance company. Filing of all insurance claims is a service that we provide to our patients as a courtesy. All charges are your responsibility If you have any questions regarding this policy, please do not hesitate to ask.


ASSIGNMENT & RELEASE

I have read all the above information and I hereby authorize my insurance benefits to be paid directly to Dr. William C Johnston, D.D.S. I understand that I am responsible for the balance on the account regardless of my insurance. In the event that an attorney or collection agency is required to obtain a debt from you, our office will be entitled to recover any fees lost during this process.

PLEASE NOTE: We REQUIRE a 24-hour cancellation notice for alt appointments! A $25.00 fee will be enforced for all no-show and short notice cancellations!!

By entering your name, you agree to the above terms and conditions

ARROW DENTAL CENTER
1561 Bienville  Dr
Monroe, LA 71201

Phone: (318) 361-0381
Fax: 318-388-4598
Johnstonwilliamc@yahoo.com

OFFICE HOURS
Mon: 8:00 AM – 6:00 PM
Tue: 8:00 AM – 6:00 PM
Wed: 7:00 AM – 5:00 PM
Thu: 7:00 AM – 5:00 PM
Fri: 8:00 AM – 5:00 PM
Sat: 8:00 AM – 5:00 PM
Sun: CLOSED