monday to friday “in the pink” plan 9.00am – 5 - smile creations dental … · 2014-07-25 ·...

Smile Creations Dental Innovations®

1A/5 Bell Alley Leighton Buzzard

Bedfordshire LU7 1DG

T 01525 383065 E [email protected]

W www.smilecreations.co.uk

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Questions or concerns

Our Dentists

Join today and start enjoying the benefits

InsuranceOpening Hours

Monday to Friday

9.00am – 5.30pm

Method of payment

D D M M Y Y Y Y

D D M M Y Y Y Y

The DIrecT DebIT GuaranTee

Please complete this form, detach it and post it to:cODeplan, elm Tree house, bodmin Street, holsworthy, Devon, eX22 6bb

D D M M Y Y Y Y

“In The Pink” PlanWorking towards… Pain Free Dentistry!

!

Your registration

Shortlisted Winner Winner Shortlisted Shortlisted



Regular dental maintenance

health examinations and hygiene

treatment are essential for an

everlasting smile and good oral health

The Smile Creations® “In The Pink” Plan

brings you the latest dental care

for a low monthly fee

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Gold –

Platinum –

Plans for children

Corporate Plans

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Dental Plan agreement

M M Y Y

Group discounts: 2 persons 5%, 3 persons 10%, 4 persons or more 15% *The following group members are included in this plan

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

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Save money on essential treatments

On an adult plan you could save up to £67 per year on

routine treatment and on the children’s plan you save £34

Enjoy even greater savings with family discounts

Why join the Plan?

Regular hygiene visits for a fresher and

brighter smile

Less likelihood of a dental emergency

The latest dental technologies used for your

treatment

Personal care and attention

Spread the cost of your essential dental care

Worldwide dental accident and emergency

insurance

Oral cancer screening

State of the art techniques in laser dentistry

Peace of mind

Relaxed and comfortable environment

We care about our patients

Family membership

What are the advantages of using the laser in our dentistry?









Spread the cost of your essential dental

care with our affordable membership

plans. Choose one that suits you best or

we can suggest one for you. Membership

gives you peace of mind knowing that

your family’s preventative care is covered.

Join now for an everlasting smile.

Gold – Saves you £57.40 per year and

spreads the cost of routine treatment.

It also entitles you to an incredible 10%

discount on additional treatments.*

Platinum – Gives you extra preventative

care and saves you £67 per year as

well as an incredible 10% discount on

additional treatments.*

Plans for children

Corporate Plans

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M M Y Y


D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

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Why join the Plan?

Name of

plan

Monthly

cost

2 Dental exams,

2 Laser hygiene

treatments, all

necessary intra-oral

x-rays, 10%

additional treatment

discount*

1 Dental exam, 2 Laser

hygiene treatments,

all necessary intra-

oral x-rays, free oral

cancer screening, 10%


discount*

2 Dental exams,

3 Laser hygiene

treatments all

necessary intra-oral

x-rays, free oral cancer

screening, 10%


discount*

Child

(5-17 years)

Under 5’s

Free

£14 ✔

Gold £20.80 ✔

Platinum £32.50 ✔

* Discount excludes all specialist dental treatment, such as: Implants, Orthodontics and Endodontics. Please enquire within for more specific information if required.

Family membership










Gold –

Platinum –

Plans for children

In addition, children also receive

special dietary advice and interactive

educational oral hygiene instructions.

Children under 5 are entitled to free

membership and for children who are

5-17 years old membership is just £14

per month.

One parent or guardian must be a plan

member.

Corporate Plans

We are also able to offer tailor made

corporate dental plans to suit the needs

of your company and ensure your

employees receive the very best dental

care at discounted rates. For further

details please contact a team member.

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M M Y Y


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Why join the Plan?

Family membership

You can save on the monthly subscription

when family members join, the family

discounts are:

2 group members – 5%

3 group members – 10%

4 group members or more – 15%


Due to the precision of the laser beam

and the varying wavelengths each laser

can produce we are able to provide more

accurate dentistry than via traditional

methods. Additional benefits of using the

laser are: faster healing, less bleeding or

swelling, reduces bacteria and they have

an analgesic effect meaning less pain is

incurred and in most cases there is no

need for injections. We have been using

lasers daily at Smile Creations Dental

Innovations® for over 20 years.









Gold –

Platinum –

Plans for children

Corporate Plans

The “DenTal SurGeOn”

Dr. Arun Darbar (BDS DGDP)Dr. Rita Darbar (BDS DOrth RCS)

The monthly fee for the gold plan is £20.80, platinum is £32.50 and the children’s plan is £14. Children under 5 are free so long as one parent or carer is on the plan.

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beTween Smile Creations Dental Innovations®

1A/5 Bell AlleyLeighton BuzzardBedfordshire LU7 1DG

Agreement start date

Title Mr/Mrs/Other First name

Surname Age Gender M F

Date of birth Dentist initials Monthly fee £


0 1 M M 2 0 Y Y


D D M M Y Y Y Y

D D M M Y Y Y Y



Date of birth Dentist initials Monthly fee £D D M M Y Y Y Y



Date of birth Dentist initials Monthly fee £D D M M Y Y Y Y

%

Total monthly fee before discount

Discount

Total monthly fee (with discount)

If you have more than 4 in your group please use another form

The “PaTIenT/Payer” T/Payer” T whO IS The cOnTracT hOlDer


Surname

Date of birth Dentist initials Gender M F

Address

Town

County Postcode

Telephone Monthly fee £

* Children under 5 do not increase group discountSave money on essential treatments




Why join the Plan?

Family membership









Our Dentists



Monday to Friday

9.00am – 5.30pm

Monthly by Direct Debit AnnuallyMethod of payment

I accept this agreement:

Patient/Payer’s signature Date

Dentist Initials Name

Signed for and on behalfof the Dentist Date

D D M M Y Y Y Y

D D M M Y Y Y Y

Data Protection Act: your data will be kept confidential but we may send it confidentially to other companies for processing payments or correspondence about your membership. By signing this Agreement you are consenting to such use of personal details.

Instruction to your bank or building societyto pay by Direct Debit

Name and address of your bank or building bociety

To the manager Bank/building society

Address

Postcode

Name(s) of account holder(s)

Branch sort code Bank account number

Reference number

Originator’s identification number

Instruction to your bank or building society: Please pay the CODEplan Ltd Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with CODEplan Ltd and if so details will be passed electronically to my bank/building society.

Signature(s) Date

Banks and Building societies may not accept Direct Debit instructions for some types of accounts.

S M I C AL R TE E

1 0 96 8 8

The DIrecT DebIT GuaranTeeThis guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits. If there are any changes to the amount, date or frequency of your Direct Debit CODEplan Ltd will notify you 5 working days in advance of your account being debited or as otherwise agreed. If you request CODEplan Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of the request. If an error is made in the payment of your Direct Debit, by CODEplan Ltd or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it back when CODEplan Ltd asks you to. You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.


D D M M Y Y Y Y


!

Your registration











Our Dentists


Simply fill out the application form then

hand it in to a team member or post it

to the address on the back of the form.

There is a one-off joining fee of £10 for

adults and £5 for children.

Insurance


includes insurance for worldwide dental

accidents and emergencies, for full

details please see the insurance Terms

and Conditions.

Opening Hours

Monday to Friday

9.00am – 5.30pm

Method of payment

D D M M Y Y Y Y

D D M M Y Y Y Y



D D M M Y Y Y Y


!

Your registration

You may withdraw from the plan at

any time by giving 3 months notice in

writing to CODEplan. See full terms and

conditions.




CODEplan Ltd administers the collection of subscriptions on our behalf; CODEplan is an appointed representative of HFIS PLC trading as Hamilton Fraser Insurance who are authorised and regulated by the Financial Services Authority.








If you have any questions or concerns,

please call the practice and speak to a

member of our team who will be happy to

help you as quickly and easily as possible.

Our Dentists

Dr. Arun Darbar (BDS DGDP)

Dr. Rita Darbar (BDS DOrth RCS)



Monday to Friday

9.00am – 5.30pm

Method of payment

D D M M Y Y Y Y

D D M M Y Y Y Y



D D M M Y Y Y Y

CODEplan.co.uk


!

Your registration




monday to friday “in the pink” plan 9.00am – 5 - smile creations dental … · 2014-07-25 ·...

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