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Wake Cross

Written Financial Policy

Time-Saving Patient Forms

Save time by completing these new-patient forms and bringing them with you to your first appointment. Print out the forms below and fill them out before your first visit.

Questions? Call us at 919-453-0777 or e-mail us today.

These forms require the free Adobe Reader application, which is already installed on most computers. If you do not have Adobe Reader, click here to download it for free. Mac Users: you can also open PDF’s using the built-in “Preview” application.


Your scheduled appointment time has been reserved specifically for you. We are aware that unforeseen events may require missing an appointment. If you do not reach out to our office within 24 hours in advance, you are subject to being charged an additional fee.

Insurance Policy & Payment Options

We are happy to file your insurance and help maximize your benefits. Because policies vary, we can only estimate your coverage due to the complexities of insurance contracts. Your patient estimation must be paid at the time of services. Insurance companies allow 30 days to render payment. If you have any questions please give our office a call so we can answer any questions or concerns you may have.

At Wake Cross Roads Dentistry we offer a variety of payments via cash, Visa, MasterCard, checks and we also offer care credit with a 12 month no interest with any 500.00 or more.