West Maple Pediatric Dentistry

14270 West Maple Road Omaha, NE 68164
Call Us: 402-491-3100
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West Maple Pediatric Dentistry
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What should you expect during your first visit to
West Maple Pediatric Dentistry?

When you and your child arrive for your first visit, please be prepared to complete all health information forms, and provide valid insurance proof or cards. This will allow us to begin treatment. We will ask you to fill out several forms that will help us become acquainted with you and your child. Once forms have been filled out, a member of our clinical staff will be with you momentarily.

After a brief stay in the waiting room filled with a TV showing current kid-friendly features and wall games, you will be escorted to our hygiene area where your first dental journey will take place. Other accompanying family members are welcome only as space permits in the hygiene area.

New Patient Forms

Please complete the forms below, print them, and bring them to your appointment with West Maple Pediatric Dentistry.

PLEASE NOTE: These forms do not digitally submit to the office.
You must print them and bring them to us.

If you have any questions please contact our office.

New Patient Form
Cancelled or Missed Appointments
Acknowledgement of Receipt
Notice of Privacy Practices

Golden Rules of Behavior

West Maple Pediatric Dentistry strives to go the extra mile in providing a service to your child. In return, we simply ask for your cooperation with the following rules to ensure only the best service for your children.

  • Please brush your children’s teeth or have them brush their teeth daily.
  • Please floss. (If you have questions about the recommended techniques, please ask. We will be happy to show you how to do it.)
  • Please turn off cell phones or set it to vibrating mood while in the Hygiene Bay area.
  • Please do not leave your children unattended in the reception area.
  • Only 1 parent should come in to prevent overcrowding of the Hygiene Bay Area or while your child is being treated. Other accompanying family members are welcome only as space and time permits.
  • Parents need to stay with siblings and friends in the waiting area if only 1 adult is present.
  • Constant opening and closing of doors to the waiting area by children is disruptive to the child being served, to other patients and to the staff.

Billing Information

West Maple Pediatric Dentistry has a payment plan to fit your needs.

Our office is committed to helping you maximize your insurance benefits. As a service to our patients, we will bill insurance companies for you. We also provide pre-estimates on your next dental treatment to help you determine how much your insurance will cover and what portion you will pay. We offer payment arrangements, you won’t be turned away.

If you have any questions, please contact our office and we will gladly assist you.