Patient Forms

Hello,

We are excited that you are interested in becoming a new patient of our dental practice.  Slavin, Jackson, Burns, DDS is dedicated to high quality dental care in a state of the art facility with a knowledgeable and caring staff.

Your initial visit is scheduled with a NYS licensed dental hygienist.  At this appointment, we will be obtaining the necessary information needed to make a complete and thorough diagnosis.  As you know, dental oral health is significantly related to your general medical condition.  Therefore, a complete oral evaluation is essential to your overall health.

The initial visit will consist of the following:

  1. Comprehensive head and neck exam
  2. Periodontal screening exam
  3. Full mouth series of radiographs
  4. Panorex radiograph
  5. Oral cancer screening
  6. Prophylaxis/Dental Cleaning (IF TIME ALLOWS)

These diagnostic tests, radiographs and preventive procedures are essential for establishing baseline information needed to assess your oral health.

In our office all fees are due as services are rendered.  As a courtesy to you we will assist you by submitting your claim to your insurance provider to receive your maximum benefit.

Once again, on behalf of the entire practice we look forward to helping you achieve optimum oral health.

Sincerely,

Dr. Slavin, Dr. Jackson, and Dr. Burns

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Meet Dr. Jackson

Meet Dr. Slavin

Meet Dr. Burns

Slavin, Jackson & Burns, Comprehensive Dentistry. Offering a Full Range of Dental Services in the Utica, NY Area.

Family Dentistry • Pediatric Dentistry • General Dentistry • Dental Implants
Pain Free Dental Procedures • Orthodontics • Root Canal
Cosmetic Dentistry • Teeth Whitening • Veneers

HAPPY CLIENTS

I felt the need to go out of my way to applaud Dr. Burns who continuously goes out of his way to show kindness & compassion to his patients. He not only provides thorough & quality dental care, but he also establishes meaningful connections with his patients which creates a pleasant & calm atmosphere for everyone involved. As a young adult supporting myself through graduate school, I appreciate not only the reasonable prices at his practice but also Dr. Burns' complete honesty about which dental procedures are crucial - you can trust his opinion wholeheartedly as he gives advice like he is offering it to a family member. I found his practice online but you bet I recommend Dr. Burns to everyone that I know. Thank you for your support!

Nicole Guzman

Slavin, Jackson & Burns DDS
2018-10-22T12:06:42-04:00

Nicole Guzman

I felt the need to go out of my way to applaud Dr. Burns who continuously goes out of his way to show kindness & compassion to his patients. He not only provides thorough & quality dental care, but he also establishes meaningful connections with his patients which creates a pleasant & calm atmosphere for everyone involved. As a young adult supporting myself through graduate school, I appreciate not only the reasonable prices at his practice but also Dr. Burns' complete honesty about which dental procedures are crucial - you can trust his opinion wholeheartedly as he gives advice like he is offering it to a family member. I found his practice online but you bet I recommend Dr. Burns to everyone that I know. Thank you for your support!
Over the years I have had a number of crowns and bridges, and I always hated the gooey impressions. The iTero eliminates all that. It is so easy and, best of all, so accurate. I have never had crowns and bridges fit better. It is an amazing mechanism.

Dena Langdon

Slavin, Jackson & Burns DDS
2017-12-20T16:03:34-04:00

Dena Langdon

Over the years I have had a number of crowns and bridges, and I always hated the gooey impressions. The iTero eliminates all that. It is so easy and, best of all, so accurate. I have never had crowns and bridges fit better. It is an amazing mechanism.
My name is Amy Gorczyka and Wayne is my husband. Since replacing the CPAP with the new oral device, he is sleeping more restful and quieter. It is so much easier for him. We are grateful he found this product.

Amy Gorczyka

Slavin, Jackson & Burns DDS
2017-12-20T16:00:39-04:00

Amy Gorczyka

My name is Amy Gorczyka and Wayne is my husband. Since replacing the CPAP with the new oral device, he is sleeping more restful and quieter. It is so much easier for him. We are grateful he found this product.
No more jaw pain. No more ear aches or headaches. No more sleepless nights -All due to THIS. The orthodic you fitted me with has relieved all that and it was immediate relief! I had been in physical therapy, but no longer need treatment. My P.T. was very pleased also!

Joyce Schmidt

Slavin, Jackson & Burns DDS
2017-12-13T19:52:54-04:00

Joyce Schmidt

No more jaw pain. No more ear aches or headaches. No more sleepless nights -All due to THIS. The orthodic you fitted me with has relieved all that and it was immediate relief! I had been in physical therapy, but no longer need treatment. My P.T. was very pleased also!
The new imaging technology for designing and precisely measuring dental crowns is remarkable. Although I have had no major issues previously, the recent crown 'snapped' in perfectly and immediately became part of my dental landscape.

Keith Fenstemacher

Slavin, Jackson & Burns DDS
2017-12-20T16:04:02-04:00

Keith Fenstemacher

The new imaging technology for designing and precisely measuring dental crowns is remarkable. Although I have had no major issues previously, the recent crown 'snapped' in perfectly and immediately became part of my dental landscape.
I feel so lucky to have met such a wonderful, caring person like you. You touched our lives in such a positive way. I want you to know your kindness has inspired me to pay it forward in many ways to help others.

Deb Seifried

Slavin, Jackson & Burns DDS
2017-12-20T16:03:00-04:00

Deb Seifried

I feel so lucky to have met such a wonderful, caring person like you. You touched our lives in such a positive way. I want you to know your kindness has inspired me to pay it forward in many ways to help others.
My wife's happy, I'm happy. I don't wake up with headaches anymore and don't get tired during the day, because I am getting my full rest at night. I am very happy.

John Evans

Slavin, Jackson & Burns DDS
2017-12-20T15:46:35-04:00

John Evans

My wife's happy, I'm happy. I don't wake up with headaches anymore and don't get tired during the day, because I am getting my full rest at night. I am very happy.
Just wonderful! I am so pleased to get rid of my CPAP machine. I wake up well rested. No snoring. Both myself and my partner are extremely happy. I would highly recommend Dr. Slavin and his staff to anyone who has sleep apnea.

Linda Lewis

Slavin, Jackson & Burns DDS
2017-12-11T18:09:01-04:00

Linda Lewis

Just wonderful! I am so pleased to get rid of my CPAP machine. I wake up well rested. No snoring. Both myself and my partner are extremely happy. I would highly recommend Dr. Slavin and his staff to anyone who has sleep apnea.
Thank you for taking the time to come and answer questions at our Cavity Free Kids Training. The teachers who attended the training noted that they found your session to be particularly informative and useful. We hope you know how appreciated you are in our community!

April and The Cavity Free Kids Trainers

Slavin, Jackson & Burns DDS
2017-12-20T16:02:14-04:00

April and The Cavity Free Kids Trainers

Thank you for taking the time to come and answer questions at our Cavity Free Kids Training. The teachers who attended the training noted that they found your session to be particularly informative and useful. We hope you know how appreciated you are in our community!
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Slavin, Jackson & Burns DDS

Rest Assured that all information provided to our office wil be strictly confidential.
Thank you for thinking of the dental office of Drs. Slavin, Jackson and Burns.