Patient Forms

Dr. Matthew Scaffa and our team are thrilled to welcome you and your family to Staten Island Dental Arts Center. Feel free to complete your patient forms before your appointment with our dentist in Staten Island, New York. This will make your appointment more streamlined. We encourage you to contact our dental office today with any questions and to schedule an appointment.

Patient Photo Consent Form

Smile Savers Plan Forms
Dr. Matthew Scaffa and our team are thrilled to offer our Smile Savers Plan to our existing and future patients who are uninsured.

 

Financial Options

Dr. Matthew Scaffa is committed to providing various payment options to meet your needs. Staten Island Dental Arts Center is in network with the following insurance companies:

  • Aetna PPO, PPO 2000
  • Assurant
  • BCBS 100, 200, 300
  • BCBS Federal
  • BCBS Premium
  • Cigna PPO
  • Connection Dental
  • DDS PPO
  • Delta Dental PPO (ALL)
  • GEHA Dental
  • Guardian DentalGuard / Preferred
  • Horizon BCBC of NJ
  • Humana PPO
  • Maverest Plus / Preferred
  • Meritain
  • MetLife PPO, FEDVIP
  • Nippon Life Ins. Co.
  • Principal PPO
  • UMR
  • United Concordia PPO
  • United Healthcare PPO

Contact our dental office to learn more about dental insurance. We also accept cash, check, credit card, and CareCredit. CareCredit is a third-party financing company that offers six- to twelve-month payment plans. For your convenience, we also offer in-office financing options for:

  • Businesses with lots of employees (Corporate Discount Plan)
  • Regular patients without insurance

We invite you to contact our office today for more information and to schedule a visit with our dentist in Staten Island, New York.

Care Credit

CareCredit health, wellness and beauty credit card
For dental procedure financing

Think of CareCredit as your own health, wellness and beauty credit card. Whether it’s oral surgery, getting a crown or a general check up, you shouldn’t have to worry about how to get the procedures you want. That’s why we’re pleased to accept the CareCredit health, wellness and beauty credit card. CareCredit lets you say “Yes” to recommended surgical and non-surgical dental procedures, and pay for them in convenient monthly payments that fit your financial situation.
CareCredit is a healthcare credit card that helps you pay for treatments and procedures for you or your family that may not be covered by insurance. With special financing options* you can use your CareCredit card again and again for your dental needs, as well as at 195,000 other healthcare providers, including dentists, optometrists, veterinarians, ophthalmologists and hearing specialists.
It’s free and easy to apply and you’ll receive a decision immediately. If you’re approved, you can schedule your procedures even before you receive your card. With more than 21 million accounts opened since CareCredit began nearly 30 years ago, they are the trusted source for healthcare credit cards.