Mobile Dental Care Patient Information – Fort Worth, TX
Care That Comes Directly
to the Patient
At LifeCycle Dental, we provide individualized, compassionate dentistry to patients who are in long-term care facilities. If you have a loved one who requires our services and we’re partnered with the nursing home that they’re in, this page contains all of the information you need so we can see them. If you have any questions or concerns, please don’t hesitate to reach out directly to our team.
New Patient Forms
Below, we’ve included downloadable versions of all of our new patient forms, whether you’re a social worker, family member, or caretaker. Just click on them, fill them out, and make sure that we receive them. If you have difficulty accessing the file, call our office so we can help your loved one get the dental care they need.
Referral Form Medicaid 1263 - Physician Non-Replacement of Dentures
HIPAA Consent Form Medicaid 1263 - POA Notice of Privacy Practices Record of Disclosure
At LifeCycle Dental, we want your family member to be able to maintain a functional smile so they can get the nutrition they need as well as smile and speak with confidence. That’s why we’re happy to accept several dental insurances, including Molina, Superior, and Delta Dental.
Fortunately, most residents in long term care have a dental benefit. The program is called an Incurred Medical Expense/ IME and is paid thru the resident’s social security. We are proficient in this program and work with the facility to provide care.
Flexible Financing Available
We want to ensure that our patients are able to receive the treatments they need, which is why we offer additional, flexible financing as needed. For more information, please contact our office.