Patient Resources

New Patient Forms

New patient forms let our team get to know you and your needs, which helps us prepare for your appointment. Filling out your new patient forms before you arrive will also help to streamline your visit and reduce your wait time. And if you have any questions, our team is always just a call away!

Putting Patients First

Fee-For-Service Care

In our mission to provide every patient with the care they need and deserve, a Fee-For-Service (FFS) approach allows us to do just that, without the restrictions put in place by dental insurance plans. While payment will be due at the time of service, we will provide you with the paperwork necessary to submit a claim to your insurance for reimbursement if you would like to use your benefits.

Keeping Care Accessible

Flexible Financing Options

We believe that everyone deserves a chance at a healthier smile. That’s why we work with some of the nation’s most trusted healthcare lenders, so you can create flexible payment plans that fit your needs, budget, and lifestyle.
WeVenue reception area
Intraoral Scanning
Oral Cancer Screening
PH Testing for Saliva
Microscopic Oral Microbiome Exam
Cleaning & Exam
Intraoral Scanning
Oral Cancer Screening
PH Testing for Saliva
Microscopic Oral Microbiome Exam
Cleaning & Exam
It's a beautiful day in the neighborhood! Stop by and say hi! 👋
It's a beautiful day in the neighborhood! Stop by and say hi! 👋

Join & Save

Our Loyalty Program

At Birmingham Holistic Dentistry, we strive to deliver exceptional dental care in a warm and welcoming setting. Our Loyalty Program is crafted to provide affordable access to high-quality dental services, ensuring you and your family can maintain excellent oral health with ease.

For an affordable annual fee, you can get all of the care you need to achieve and maintain a healthy smile. Plus, you’ll receive exclusive discounts on any additional treatments, all without relying on dental insurance.

Preventive Care

Preventing oral health issues is our primary goal at Birmingham Holistic Dentistry, which is why cleanings and regular exams are included as a part of every membership.

Discounts On Treatment

It pays to invest in your oral and whole-body health. When you become a member, you’ll receive discounts on all recommended treatments at our practice.

Emergency Exam

Emergencies can happen when you’re least expecting them. But as a member, you can rest easy knowing that emergency exams are covered under every plan.

Plans for Every Need

Getting the high-quality dental care you deserve doesn’t need to be complicated. That’s why we have a loyalty plan for every member of the family.

Adult Loyalty Plan

$699/year

Ages 15 & over

  • All oral exams
  • 2 Cleanings
  • Periodontal Charting
  • Oral Cancer Screening
  • All X-rays, excluding CBCT

Perio Loyalty Plan

$799/year

For adults with periodontal disease

  • All Oral Exams
  • 3 Periodontal maintenance Cleanings
  • Periodontal Charting
  • Oral Cancer Screening
  • All X-rays, excluding CBCT
  • Extra Perio Maintenance Cleanings

Child Loyalty Plan

$399/year

Ages 3 - 14

  • All oral exams
  • 2 Cleanings
  • Periodontal Charting
  • Oral Cancer Screening
  • All X-rays, excluding CBCT

Membership Details

  • To be an independent member, you must be 18 years or older.
  • This plan cannot be combined with any other dental insurance.
  • This plan cannot be combined with any other offers.
  • All patients are subject to Birmingham Holistic Dentistry office policies.
  • Plans and fees are subject to change yearly.
  • No discount is provided for services requiring referral to a specialist.

Payment and Terms

  • A payment plan CANNOT be used for enrollment fees.
  • All payments for treatments must be paid in full at the time of check-in to receive a discount.
  • Any services that are not paid in full at the time of service will be billed at our regular fees.
  • No refunds will be given if a member does not use the plan benefits, relocates, or obtains dental insurance.
  • 12 months term begins the day of sign-up.
  • Two no-shows or cancellations without 48 business hours notice will result in being dropped from the program without refund.

You Deserve The Best

Please do not submit any Protected Health Information (PHI).
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.