Referrals & Membership
Finally, an office that rewards you for referring your friends and family! You do it anyway, so why not get something for it? Simply pass out this referral card to your family and friends*. Remember to write your name, phone number, and e-mail address on the back. The person you referred will receive $25 toward their first visit or a gift card worth the same amount when they bring this card to their first appointment. Once they have been seen by us, you will also receive a $25 gift card or credit towards any dental treatment you need. It's up to you!
*Comprehensive New Patient Exams Only
Click on the link below to print out the back page of the referral card. Simply fill it out with YOUR information and give it to a friend or family member and have them bring it to their appointment. You will both be rewarded!
The Diamond Dental Membership Plan is an annual reduced fee dental plan that allows individuals and families – just like yours – to receive the quality, high tech, caring service that our practice provides at prices that make sense for our current economy. This plan offers the economy of group dental care but with the individualized attention of private care.
If not covered by any dental insurance plan, you and your spouse are eligible, as well as children under the age of 18 or full time students up to age 23. Coverage of children over the age of 18 will continue if the child has a developmental disability or a physical handicap which makes them incapable of sustaining employment. Children may be members only as dependents of adult members. Proof of student status must be provided before students will be added to the plan. Benefits begin immediately. Members must remain in the plan a minimum of 12 months.
All payments at the reduced fee level are made directly to Diamond Dental on the day treatment is performed. Our plan is also available to employers at a discounted group rate. E-mail us at firstname.lastname@example.org for details.
- Your Diamond Dental Plan Membership provides you with up to two simple teeth cleanings per year, local anesthetics, two examinations and four bitewing x-rays at NO CHARGE.
- Your membership also provides you with a 15% reduction in our usual fees for other dental services. Unlike dental insurance plans, there is no yearly maximum or deductibles to meet.
- Periodontal Membership covers up to 4 periodontal maintenance visits along with the above benefits annually.
- Orthodontic procedures and upper and lower complete dentures are not covered by this plan.
- In order to determine which plan best suits the patients need, patients who have not previously had a Comprehensive Exam must have an exam before entering the plan. This exam is $71 and includes all necessary X-Rays.
- 1 Adult Member = $250 annually
- Member with 1 dependent = $462 annually
- Each additional dependent = additional $190 annually, per dependant
- Periodontal Membership = $450 annually
USUAL AND CUSTOMARY FEES FOR BENEFITS
- The benefits covered in the child package at our usual fees for 2 cleanings, 2 sets of X-rays, 2 exams, and 2 fluoride treatments are $304.
- The benefits covered in the adult package at our usual fees for 2 cleanings, 2 sets of X-rays, 2 exams and 2 fluoride treatments are $342.
- The benefits covered in the standard periodontal package at our usual fees for 4 periodontal cleanings, 2 sets of x-rays, 2 exams and 2 fluoride treatments are $634.
All payments are made directly to the dental office. A deposit of 25% of the total procedure amount will be due on the day the appointment is scheduled. The rest of the balance must be paid in full on the day the procedure has been performed. Interest free payment plans are offered with approved credit through Care Credit. When Care Credit payment plan is used, the amount of the discount given on treatment is only 5%.
This plan is only offered at our office located at 1991 South Douglas Boulevard, in Midwest City, Oklahoma. It is offered for care received during office hours only.
Our office hours are: Monday & Tuesday: 9:00 am – 6:00 pm
Wednesday & Thursday: 8:00 am - 5:00 pm
Friday: 7:00 am - 3:00 pm
The provider for this plan is Brent T. Amaya D.D.S..
Once you have completed the form you can either: E-mail it to email@example.com, fax it to (405) 733-2250, mail it to 6912 East Reno Avenue, Suite 200, Midwest City, OK, 73110 or simply bring it in to our office.We are always happy to see you!
You will then receive an exclusive Membership card from us! If you would like to pay your membership fee by check, either mail it in with your enrollment form, or bring it by our office. Thank you, for entrusting us with your oral health care!
- Dr. Amaya and your Diamond Dental Team