Orthodontist in Saratoga and San Jose, CA (California), Dr. Brian J. Nettleman

Please help us be prepared for your first appointment by completing this Patient Form. Download the form below in Word or PDF format, print it out, complete the form, and bring it with you to your first appointment.

Download Adult Patient Health History Form (PDF)

Download Child Patient Health History Form (PDF)

Regular Appointments

The appointment when you get your appliances (braces, expanders, etc.) usually takes from one to two hours. You'll then see us at regular intervals 8 to 10 weeks apart for an adjustment, which takes 20 to 40 minutes. Our regular office hours are Monday and Tuesday 8:00 AM to 5:00 PM, Wednesday and Thursday 7:00 AM to 4:00 PM. The office is closed on Fridays. Patients are seen by appointment only. We make every effort to be on time for our patients, and ask that you extend the same courtesy to us. If you cannot keep an appointment, please notify us immediately. Cancel only if it is an emergency. It is difficult to reschedule you since most appointments are made 8 to 10 weeks in advance.

Payment & Office Policies

Cost

The cost of treatment depends on the severity of the patient's problem. You will be able to discuss fees and payment options before treatment begins. We have payment plans to suit different budgets, including a no-down-payment option. We also accept assignment from most insurance plans, and file the necessary papers to the insurance company. We work hard to make orthodontics affordable.

Fees

In an effort to keep orthodontic fees down while maintaining the highest level of professional care, we have established this financial policy:

If full payment is made at the onset of treatment, we will offer a fee discount. (If you have insurance, we will offer a discount for payment of your portion of the fee that will not be covered by insurance.)
To fit your individual needs, financial arrangements can be made to extend your payments over a period of months.
For your convenience, we accept Visa, Mastercard and American Express.
In cases of serious delinquency, treatment will be discontinued, although we will make every effort to accommodate patients with temporary difficulties.

Insurance

If you have insurance, we will help you to determine the coverage you have available. We ask that you assign your insurance benefit to us. The balance will be arranged for you to pay (see above). Professional care is provided to you, our patient, and not to an insurance company. Thus, the insurance company is responsible to the patient and the patient is responsible to the doctor. We will help in every way we can in filing your claim and handling insurance questions from our office on your behalf.

Orthodontist Brian J. Nettleman
Saratoga Office: 18805 Cox Ave., Ste. 150, Saratoga, CA 95070 Tel: 408-379-1400
San Jose Office: 2664 Berryessa Rd., Ste. 108, San Jose, CA 95132 Tel: 408-272-4344