Patient Information


Patient Form

We want your first visit with Dr. Bezik to be an efficient, encouraging time. To help streamline your visit, we have provided our patient forms online. We invite you to fill them out before coming to the dentist for your initial appointment. To use, simply click on the link below to download and print our forms from your computer. You can complete them in the convenience of your own home, then bring them with you to your appointment. If you need any help, please contact our dentist in Fairfax, VA, today. We are excited to meet you and look forward to having you as part of our dental family.

Payment Options

Insurance

We will happily help you utilize your dental insurance plan. If you have any questions about your insurance, please give us a call. Our trained staff can help you find the answers you need.

Other Payment Options

To make things easiest for our patients, we give you the following options for your payment:

If you have any questions about our financing options, please get in touch.

Personalized
Treatment
Prevention &
Maintenance Focused
Healthier,
Beautiful Smiles
Personalized
Treatment
Prevention &
Maintenance Focused
Healthier,
Beautiful Smiles

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We Strive To Make Your Dental Visits A Pleasure!

Use the form to request a booking. You can also call or email us to schedule an appointment.

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Appointment Form