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Patient Information

Before your initial visit, please provide the following:

  1. Completed Forms: Registration and medical questionnaire (sent by our office).

  2. Referral Slip & Radiographs: Have your dentist send digital x-rays to ekelmanperio@gmail.com one day before your appointment. If x-rays are older than one year or incomplete, we will take new digital x-rays.

  3. Insurance Information: Provide completed insurance details, including your spouse/partner's info if they are the primary subscriber. We accept certain plans and submit claims electronically—accurate, up-to-date information is essential for efficient processing.​

Medical Concerns: Please notify us if you have any medical conditions (e.g., artificial heart valves, blood thinners, diabetes, organ transplants) before surgery. For antibiotic prophylaxis updates, visit www.ada.org.

Bisphosphonates: Please inform Dr. Ekelman if you're taking intravenous (IV) or oral bisphosphonates. Recent studies have shown that patients who take IV bisphosophonates (Reclast and Prolia) are at high risk for developing painful refractory bone exposure as known as osteonecrosis of the jaw. Prolonged used of bisphosophates may suppress bone turnover which contributes to lack of bone repair and delayed healing process. Very few cases of osteonecrosis of the jaw have been reported following oral bisphosophonates. (Scully C et al. Implant Dent 2006;15:212-218). For further information, visit www.perio.org or www.ada.org.

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