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Menu
  • Services
    • Diagnostic & Preventative
      • Dental Cleanings & Checkups
      • Digital X-rays
      • Fluoride Treatment & Dental Sealants
      • Oral Cancer Evaluations
    • Orthodontics
      • Braces
      • Invisalign®
      • Orthodontics FAQs
      • Orthodontics for Children
    • Periodontics
      • Gum Disease Treatment
      • Deep Cleaning
      • Scaling & Root Planing
    • Prosthodontics Dentistry
      • Implants
      • Crowns & Bridges
      • Partial & Full Dentures
    • Cosmetic Procedures
      • Whitening
      • Veneers
    • Restorative Dentistry
      • Crowns
      • Fillings
    • Oral Surgery
      • Extractions
      • TMD/TMJ Treatment
    • Endodontics
      • Root Canals
    • Emergency Care
    • Pediatric Dentistry
  • AFFORDABILITY
    • Dental Insurance Plans
    • SageCare+ Discount Dental Plan
      • SageCare+ Savings
      • VIP
    • Financing Options
  • CAREERS
  • NEWS
  • COVID-19
  • Pay My Bill
  • Find Locations

PATIENT FORMS

Thank you for choosing
Sage Dental.

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We can’t wait to meet you!

To save time at your visit, we have provided forms below that you may print, fill out, and bring in with you to your appointment.
SAGE DENTAL New Patient Registration Form – English
SAGE DENTAL New Patient Registration Form – Spanish
These forms are in PDF format. You will need Adobe Acrobat Reader to view these. Click here to get Reader.

SageCare+ Discount Dental Plan

Don’t miss your chance to save up to 65% and keep
your smile healthy with your SageCare+ Membership

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Call us

Call us anytime at
855-697-2439 and we’ll
be happy to help.
Call now
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Visit us

Enroll in SageCare+ at
your local Sage Dental Office
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Enroll online

Simply click Enroll Now
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enrollment process.

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Menu
  • About us
  • Our Services
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  • Find Locations

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COPYRIGHT © 2022 – SAGE DENTAL MANAGEMENT, LLC. ALL RIGHTS RESERVED
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Disclaimers
New Patient Package Disclaimer:
  • Free Exam and X-rays Valid for new patients for appointments completed between 10/1/2022 and 12/31/2022 ONLY. Must mention offer to redeem. See practice for details. While supplies last. Not valid for HMO patients or Medicare/Medicaid participants.
  • Free Whitening Kit FREE Opalescence® Go Mini whitening kit with the completion of new patient hygiene treatment. Eligible for new patients only. Must mention offer to redeem. Valid for appointments completed between 10/1/22 and 12/31/22. See practice for details. While supplies last. May not be combined with Dental HMO, PPO, government reimbursements, or other discounts.
Orthodontics Consult Disclaimer:
Free orthodontics consultation (D8660) available with appointment to any Sage Dental location. Must mention offer to redeem. Dr. Antonio R. Cruz, DN 12876, Sage Dental Group of Florida, PLLC, 951 Broken Sound Parkway, Suite 250, Boca Raton, Florida 33487. Dr. Cindy Roark DN013293 Sage Dental Group Of Georgia, PLLC, 951 Broken Sound Parkway, Suite 250, Boca Raton, Florida 33487.
Care Credit Disclaimer:
Subject to credit approval. Minimum monthly payments required. See carecredit.com for details.
**VIP Disclaimer:
VIP Discount Program is not dental insurance. Membership fees are non-refundable. Discounts shall not apply to any treatment started prior to enrollment or after membership expires. Discounts shall not apply to treatment paid in full or in part by an insurance policy. Fees may be changed at the discretion of Sage Dental at any time during the plan period. Discounts cannot be applied to insurance copayments or deductibles. Discounts cannot be combined with insurance benefits, other special offers or sales promotions advertised by Sage Dental, any third-party discounts, coupons, offers, or other dental discount plan benefits. Minimum fees only. Excludes all retail products. Florida Residents: Dr. Antonio R. Cruz DN12876. Georgia Residents: Additional charges may be incurred for related services which may be required in individual cases. Dr. Cindy Roark DN013293.

Florida Residents:

THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.

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