New Patient Forms

Dental In House Insurance Program

At Summer Creek Dental, we strive to make every patient comfortable while providing affordable dental treatment.

With our In-House Insurance Program, each enrolled member will receive two exams, two cleanings* and necessary x-rays yearly. You will also receive a 35% discount on all services for one year. (Excluding cosmetic services, including but not limited to: Invisalign, teeth whitening and veneers)

$300.00 is due at the time of contract signing and will be good for 365 days. At the beginning of the next contract year, if the patient wishes to continue with the program, a new contract and/or rates may apply.

Immediate family members may also be covered under the program for an additional $250 each for NON-periodontal patients, and $350 each for periodontal patients (regular price $350). Immediate family members consist of: spouse and/or significant other, children up to age 18, or full time students up to age 26.

Below are the terms and conditions for using the In-House Insurance Program:

*Two cleanings a year includes basic prophylaxis. This service is provided for children and adults who are in excellent health with no bone loss, recession, or inflammation. A prophylaxis (or prophy) by definition is cleaning plaque, tartar and stain from the enamel tooth portion above the gums only. This does not include periodontal treatment (deep cleaning, SRP, full mouth debridement, etc.) I understand that I may not use dental or medical insurance in conjunction with this program. No refunds or cancellations. Initial payment is due on contract signing date. Co-pays for treatment are due on the date of service. I understand if I fail to pay my co-pays at the date of service, my account will be sent to a collections agency and the contract will no longer be in effect.

I understand that in the event I have to be referred to a specialist of any kind for additional treatment, this discount does not apply. (Discount is only valid at Summer Creek Dental)

**We have an additional program for PERIODONTAL patients, please contact the office for more details.

Please call or e-mail us with any questions that you may have, we are happy to help! 281.454.2000 [email protected]

Care Credit Dental Provider

CareCredit is a healthcare credit card that makes care possible today - for purchases of all amounts. It is a credit card designed for your health, beauty and wellness needs. With many of our special financing options, you can avoid paying interest by making your minimum monthly payments and paying the full amount due by the end of the promotional period. 

Unlike your Visa or MasterCard, the CareCredit healthcare credit card offers special financing options. With shorter term financing options that range from 6 to 24 months, no interest will be charged on purchases of $200 or more if you make your minimum monthly payments and pay the full amount due by the end of the promotional period. Interest will be charged to your account from the purchase date if the promotional balance, including optional charges, is not paid in full within 6, 12, 18 or 24 months (if you qualify). Minimum monthly payments are required.

If you need more time to pay for your procedure, we also offer longer programs with a reduced, fixed interest rate. The fixed monthly payment amount is based on repayment over a 24, 36, 48 or 60-month period. Purchases of $1,000 or more are eligible for a 24, 36 or 48-month offer and purchases of $2,500 or more are eligible for a 60-month offer. For complete details, please visit

Cherry Financing

We now offer the leading treat now, pay later solution through Cherry, which allows you to pay for your treatment over time. Apply for up to $25,000 with Cherry via our link today, no hard credit check required! Pay with Cherry using three simple steps:

1. Apply through our Cherry link to see how much you're approved for.

2. Remind our staff that you'll be paying with Cherry when you arrive for your appointment.

3. Choose the payment plan that works best for you and checkout with our front desk.