Patient Registration

Please complete your patient registration online at www.ezrootcanal.com. On the home page, go to the “Patient Login” area. Your User ID and Password will be emailed to you from our office.  If you do not receive this email and it did not go to the junk email, please call us so we can make sure you receive that.

After logging in you will need to complete the following sections: Patient Registration, Medical History and Pain History.  Please remember to click the “Submit” button at the bottom of each section to save your information. We ensure that this web site is completely secure and your information will remain confidential.  Here you may also find directions to our office and information about endodontic treatment.

When you arrive for your appointment, we will request your signature for each of these forms. You will also be asked to sign our Consent for Treatment.  You may review a copy of this consent form online as well.

In order to provide the best possible service, we do ask that you give a 24 hour notice for cancelled appointments.  We have reserved your appointment time and will need to confirm with you the day before your treatment.

We will file your primary insurance as a courtesy for you.  We will also give you a pre-estimate of the procedures that have been recommended by the doctor before treatment is initiated.  Please remember that this is only an estimate.  We will not know the exact amount that your insurance will pay until they send us the EOB with payment.  We try to get this as close as we can with the information that your insurance supplies us but it is only an estimate.  You will be required to pay your estimated portion at the time of service.  We accept all major credit cards and cash.  We also accept care credit.  

If you have any questions along the way, please contact our office immediately at ACE Endodontics Phone Number 713-468-8264.  We look forward to meeting you very soon.