Blossom Dental
and Facial Aesthetics:
New Patients Form and Payment Options

Call: 386-947-7603

Blossom Dental and Facial Aesthetics Ormond Beach – New Patients Form

For your initial visit, kindly provide the following:

  1. A comprehensive medical and dental history.
  2. A list of medications you are currently taking.
  3. If you’ve had any X-rays in the last year, please email them to us at before your visit.
  4. If you have insurance, please bring any forms or insurance benefit cards (both dental and medical) to the appointment.

Please note that all patients under 18 must be accompanied by a parent or guardian at the consultation appointment.

You can pre-register with our office by clicking the Patient Forms buttons below. After completing the forms, remember to press the Submit button. Your information will automatically be entered into our system, saving you from refilling them during your initial visit. Rest assured, all information collected online is encrypted to ensure your privacy.

If you are a new patient to our office, you may complete the online form below. Thank you, and please feel free to contact our office if you have any questions.


We accept most PPO insurance plans. Please provide us with your insurance cards (both dental and medical) and leave the rest to us, our experienced staff will call your insurance company and process your claim for you.

Payment Options

Cash, Personal Checks, and All Major Credit Cards Accepted at Blossom Dental and Facial Aesthetics in Ormond Beach, FL

Ensuring a seamless experience, Blossom Dental and Facial Aesthetics in Ormond Beach accepts various payment methods. From cash and personal checks to all major credit cards, we provide you with flexible options to settle your payments conveniently. Our commitment is to prioritize your comfort at every step of your dental and facial aesthetic journey. 

Financing Options at Blossom Dental Ormond Beach

Explore flexible financing options at Blossom Dental and Facial Aesthetics in Ormond Beach. Our partnerships with PatientFi, LendingClub, and CareCredit provide you with a variety of choices for a seamless experience.

Click on your preferred financing option’s logo to start your Application:

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Blossom dental ormond beach
blossom dental and facial aesthetics ormond beach financing dentistry

If you have any questions about our payment process or need assistance, feel free to reach out to our friendly team. Your satisfaction is our priority, both in the quality of care you receive and the ease of managing your payments. Choose Blossom Dental and Facial Aesthetics for a stress-free and enjoyable experience.

Call: 386-947-7603

Take the first step towards a brighter smile you’ll love. Schedule a consultation at Blossom Dental

Office Hours

Monday-Friday 8:30am-5pm.

Emergency Dentistry

Receive prompt and compassionate emergency dental care at Blossom Dental and Facial Aesthetics in Ormond Beach. We offer same-day urgent dental care appointments and weekend availability, ensuring swift solutions for your urgent needs. Trust us as your reliable emergency dentist for a pain-free experience.

Schedule your appointment today.

Please book your appointment with our trusted dentist in Ormond Beach today and get started on your smile makeover journey toward a beautiful smile.

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