New Patient Forms & Payment Solutions



You may access the following forms to assist us with your care. The link will take you to a secure site. All of your informaion is secured and confidential. Please click on the required link below, fill out the form, sign as needed and click the "Submit" button. We look forward to seeing you soon.

Submit New Patient Medical History Form



Managing your budget is just as important as managing your health. The Dental Implant Institute is pleased to present flexible payment plans through Lending Club Patient Solutions. Enjoy a selection of flexible plans with low fixed rates and monthly payments, no upfront payment, and no prepayment penalty.

It’s easy to calculate your potential monthly payments. Simply complete a short application which displays fixed rates and monthly payments available for Extended Plans, all without impacting your credit score.

 Plans with low fixed rates & low monthly payments that never change over the life of the loan
 Patient-friendly, True No-Interest Plans with no retroactive interest
 No upfront payments
 No prepayment penalty

Privacy / Security

Your privacy and security are important to us. As part of our commitment to protect you, we employ a number of technologies and processes to protect your personal and financial information.

FAQ / Contact Us

For answers to common Lending Club Patient Solutions questions, please refer to the frequently asked questions (FAQ) list. If you require additional assistance regarding your Lending Club account, please contact the Lending Club directly.


Dental Implant Institute
6170 West Desert Inn Rd
Las Vegas, NV 89146
Phone: 702-867-2941
Fax: 702-247-4014
Office Hours

Get in touch