Patient Information
CharlottePerio offers the convenience of paying your bill online quickly and securely.
In order to pay your bill online, please choose the corresponding link. You will need access to your Account Number. This information is available on your account statement.
If you have any additional questions please call our office at 704-365-0123.
Financial Arrangements
We understand that every person’s financial situation is different. For this reason, we are happy to provide a variety of payment options to help you receive the periodontal care needed to enjoy a healthy mouth and confident smile. These options include deferred interest plans administered through Wells Fargo Health Advantage and Care Credit.
Dental Insurance
As a courtesy to those patients with dental insurance, we are happy to assist you in determining the benefits that may be available to you for proposed treatment in our office. In order to do this, we will need the below form completed or a copy of the front and back of your dental insurance card. We will make every effort to help maximize your benefits, but ultimately, you will be responsible for all fees for services provided.
Patient Forms
You can access our online forms by visiting the “FORMS” button below.
Forms available:
- New patient packet (adult and minor)
- Medical History packet
- Dental Insurance Information
