Patient Forms

Click here to download the Form Packet — and bring the completed forms to your appointment.

• Financial Policy
• Dental Registration & Insurance Information
• Health History


Insurance Information

At Kuehn Family Dentistry we work with you to process your insurance for covered procedures. We will ask you to provide us with basic information about your insurance coverage and then we will confirm eligibility and determine your estimated co-pay prior to treatment. As a courtesy, we will also file the claim for you.

The insurance policy is a contract between the patient and the insurance company. We strive to get the most accurate and updated information as possible. However, deductibles, maximum benefits and claims in process can change the benefits paid on your claim. Any unpaid balance by the insurance company may be due by the subscriber. You may be billed or refunded after the insurance has paid its benefits.

If you have any questions, please call 412.886.9999 and talk with our staff.

The following are the insurance companies we currently participate with. PPO plans only.

Chip (United Concordia)
Delta Dental
Sun Life
United Concordia
United Healthcare
UPMC Advantage



T. John Kuehn, D.M.D.  & Associates   |   Kuehn Family Dentistry   |   1201 Broughton Road, Pittsburgh, PA 15236   |   412.886.9999
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