Patient Information


Thank you for choosing our office for your dental needs.  We realize that every person's financial situation is different.  For this reason, we have worked hard to provide a variety of payment options to help you receive the dental care you need and deserve. This allows you to enjoy a healthy, beautiful smile with respect to your budget.  Dental treatment is an excellent investment in an individual's medical and psychological health.  We are always available to answer your questions or assist you in any way we can.
Payment is due on the day services are rendered, unless prior financial arrangements have been made with our office manager.
We will submit your dental insurance at no extra charge to you, and we expect you to pay your portion of the bill on the day of service.  If insurance reimbursement is not received at our office or your claim is denied, you will be billed the balance due.
We will file most insurances for you.
Methods of payment accepted:  Cash, Check, Visa, MC, Amex, Discover, CareCredit
      We also offer affordable finance options, including 0% interest

Patient Forms

Your First Appointment

Please click on the link below to download our patient information form, health questionnaire, and HIPPA privacy notices.


You can print these forms, fill them out, and bring them with you to your first appointment.

New Patient Forms
Office Forms.pdf
Adobe Acrobat document [244.2 KB]

Other Forms:

Request for Records
This form allows you to request a transfer of your dental records from your previous dentist to our office.
Request for Records.pdf
Adobe Acrobat document [42.6 KB]
Release of Records
This form allows you to transfer your dental records from our office to another dentist.
Release of Records.pdf
Adobe Acrobat document [44.1 KB]

Contact Us Today!

Nathan B. Klein DDS

7611 State Line Rd, Ste 140
Kansas City, Missouri 64114

Phone: 816 822-1800 816 822-1800


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© Nathan B. Klein DDS 7611 State Line Rd Ste 140 Kansas City, MO 64114 816-822-1800