Thank you for your interest in our In-Office Dental Membership plan!

What’s included:

• Examinations
  • New patient/comprehensive exam 100%
  • Periodic exam 100%
  • Limited exam 100%
• Radiograph
  • Full mouth series (one 5/years) 100%
  • Bitewings (1 set/year) 100%
  • Periapical (first film and 2 add 1/year) 100%
• Preventative Care
  • Adult cleaning (2/year) 100%
  • Child cleaning (2/year) 100%
  • Fluoride (1/year, must be under 16) 100%

Annual Membership Dues

Note: All family members must reside in the same household

• First family member: $400
• Second and third family member: $350/each
• Any additional members: $300/each

Benefits Of Membership

• NO pre-authorization required
• NO annual maximum
• NO deductible
• NO waiting period or pre-existing exclusions
• Cosmetic dentistry included

All Other Services at 20% Discount

Except Invisalign and Zoom

• Periodontal therapy/scaling & root planning procedures.
• Fillings, cosmetic dentistry, crown, bridges, root canals.
• Extractions, dentures & partial, implants restoration ONLY.

Care Beyond the Chair Program

We are excited to announce our Care Beyond the Chair program. As a patient of our practice, you can now receive a $200 personalized electronic toothbrush for just $130 You will receive FREE replacement brushes on your routine visits. This can be gifted, at the perfect time for Graduation and Father’s Day. What better gift than the gift of health?

Terms & Limitations of the Plan

• Family members cannot be substituted in for another family member.
• Your effective date is the day you sign up and your renewal date is the same date every year.
• This is a dental discount plan and NOT dental insurance. It can not be combined with any other dental insurance.
• Payment is due at time of service for any treatment rendered.
• Rates are subject ro change annually.
• Membership dues are NOT refundable.
• Children must be under the age of 26 AND a full-time student.
• Membership is only vaid at PDM Family Dental, and therefore you are referred to a specialist, discounts offered to members will NOT apply.

How to Get Started

Print the form from the following PDF link, fill out the form at the bottom, and bring it with you to your next appointment!

Please contact us today if you have any questions or concerns.