Bellevue Office
New Patient Forms

Save time, take care of the paperwork now.

Our New Patient Forms are now available for download so that you can complete your form at your convenience. This gives you the time you need to carefully review our policies and procedures outside of the office and makes your first visit easy. Click on the link below to download the form, print it out and bring it to your first appointment.

Bellevue Office
Payment Options

We are committed to providing dental care that is both high quality and affordable.

Payment options include Cash, Checks, Visa, MasterCard, Discover, American Express and CareCredit.

Visa MasterCard Discover American Express CareCredit

Pay Online - Bayliss Park location
Enter name in the field and click "submit"

Pay Online - Bellvue location
Enter name in the field and click "submit"

Payment is required at the time services are performed. Other financial arrangements are available when extensive dental care is necessary, or when the dentistry performed exceeds your budget or insurance benefits. We will be sensitive to your financial circumstances within the framework of sound business practices.

We understand that unexpected dental bills can strain finances. If this happens to you, don't hesitate to call us at (402) 291-6577. If you keep the line of communication open with us, we will be able work out an acceptable arrangement.

For questions about payment and financing, please contact our office. We are happy to help!

Bellevue Office
First Visit

We need your trust and help to accomplish this goal, especially if your child is anxious.

We ask that you discuss positive aspects of dentistry with your child. Convey good feelings about dental visits as being part of growing up. Use positive words with your child like "gentle" and "fun," rather than "won't hurt" or "not scary" because the words hurt and scary are likely all they will hear.

When you don't know the answer to a tough question, it is OK to reassure your child by saying something like "I don't know but we'll be sure to ask Dr. Hajek at the beginning of your visit." Anxiety is fear of the unknown, and letting Dr. Hajek answer your child's questions may be all they need to feel comfortable. Together we can make your child's dental visit a happy one.

P.S. Please don't worry or be upset if your child fusses or cries. It's just another way for children faced with a new or unusual situation to communicate. Remember their first hair cut or picture with Santa?

Bellevue Office
Appointment Request

If you are a current patient of our office and are experiencing an after-hours dental emergency, you may call our emergency line at (402) 291-6577.

We believe in delivering the best dental care possible