Dental Savings Membership Plan Contract
Applicants are required to accept these terms and conditions before purchasing a membership and receiving its benefits. 479 Dental Care reserves the right to make changes to these terms and conditions at any time.
This is a dental discount plan and is NOT dental insurance. It cannot be combined with any other dental insurance.
The effective date of this plan is the day you sign the agreement, and the automatic renewal date is that day of the month every month after the agreement date.
Exams, x-rays, cleanings, and fluoride must be performed within the year of enrollment and cannot be carried over to the next year.
The two cleanings included in this plan are for standard cleanings only. Scaling and root planing treatment of periodontal (“gum”) disease is not included.
Payment is due at the time of service for any work not covered 100% by this plan.
Extended payment plans, including third party financing plans, may not be used in conjunction with this Membership Plan.
Payment of less than the plan’s duration membership fees may result in being charged usual and customary fees for all services (including those already provided) and being charged remaining months’ fees in a lump sum.
This is an in-house Dental Membership Plan that is only valid at the office of 479 Dental Care. It cannot be used at any other location and it cannot be combined with any other in-network dental insurance.
Should there be dental treatment needed following any type of injury where a lawsuit, and therefore outside medical, care, disability, or workers comp type insurances are involved, this discount plan cannot be used.
This plan is non-transferrable. Family members cannot be substitutes for another family member.
This plan is non-refundable. No refunds are given if patient chooses not to use their dental plan after enrollment.
Members must maintain membership throughout the duration of clear aligner treatment.
Eligible for dental services only, products are not included.
No additional discounts or coupons will be applied.
A fee (based on length of appointment) may be incurred for each broken appointment without a 24-hour advance notice or termination of membership may ensue.
Rates are subject to change annually.
479 Dental Care reserves the right to cancel or discontinue this plan for any reason at the end of the Membership term.
Services not utilized may not be “rolled over” to the next year or transferred between family members, plan participants, or any other individual.
Member must give 30 days notice to cancel their membership. After cancellation, member must then pay the full price for their next diagnostic/preventative/radiograph/treatment appointments.
The member agrees and understands that they are entering into a binding contract by accepting the Terms and Conditions.
Renewal of Membership:
It is the responsibility of the members to supply 479 Dental Care with current payment information to process a membership renewal without a lapse in membership.
In any event, it is the responsibility of the member to ensure that 479 Dental Care has received payment for membership prior to the expiration date. 479 Dental Care is not responsible and assumes no liability to any member for failure to provide 479 Dental Care with current payment information for membership renewal.
I agree to the terms and conditions contained herein. I acknowledge and agree that the Dental Membership Plan offered by 479 Dental Care is not an insurance plan; it is a membership plan offered to provide a discount for select services provided at 479 Dental Care at 1404 SE Eagle Way, Suite 2, Bentonville, AR 72712 ONLY.
Please direct all questions to:
479 Dental Care 1404 SE Eagle Way, Suite 2 Bentonville, AR 72712 479-448-8383 Hello@479DentalCare.com
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