Downloadable Forms

Steven G Mautner D. D. S., P. A. Provides the following office documents for your access online. You will need the free Adobe Acrobat Reader to view and print these documents. If you do not have it you may download and install it for free at Adobe.com

Forms Required For All New Patients

In house dental plan
New patient form
New patient form SPANISH

Frequently Asked Questions

1. What days are you open? We are open Monday through Thursday 8 to 5 and Friday 8 to 12.

2.Do you take emergencies? Emergencies are seen the same day. Patients are free to call and we will work them into the schedule or they can come in without an appointment Monday  through Thursday 8 to 12 and Friday 8 to 10. For after hours, Dr. Mautner can be reached by a voice mail service.

3. What is the new patient process?  Unless they have a specific problem such as a toothache or broken tooth or denture, new patients are first seen for a complete exam which includes a full set of x-rays and then if the condition of their mouth is healthy are scheduled for a cleaning.We normally verify insurance before the initial appointment also.

4.How much do you charge for a deep cleaning?  This is a very common question, as many patients are told they have "gum disease" and require a deep cleaning to treat it. Actually the dental term for this procedure is root planing/ curretage and this requires local anesthetic and either the dentist or hygienist going below the gumline and removing all of the plaque and calculus present. Dr. Mautner charges $480 for this procedure on his in-house dental plan. However, he has found that this is commonly overprescribed, so before this question is answered an exam with x-rays is required.

5. What type of anesthesia is used? Dr. Mautner uses a very strong local anesthetic, 4% Septocaine with 1:100,000 epinephrine or 3% Mepivacaine for those who can't be administered epinephrine. For the vast majority of patients this enables the procedures to be done painlessly.

6.Do you see children? Dr. Mautner sees children starting at age 5. If they are uncooperative or require complex treatment they are referred to a pedodontist (children's dentist).

7.How is payment handled? Payment is required at the day of treatment, by cash , check or any credit or debit card. For those with insurance, we accept assignment for the balance after the patient's copayment (if any) or deductible.

Delta, Guardian, Metlife, Aetna, Humana, Care Plus, Physicians United, all New York City Union Retiree Plans, Compbenefits, Cigna, UFT (Aetna), Medicare Advantage Plans, Ameriplan, American Dental Care and many others.  Please feel free to call if you don't see your insurance plan on this list. We probably accept

Your First Appointment
Insurance and Payment Information | Privacy Practices

Your First Appointment
Please bring the following:

* Patient's insurance card
* Referral(s) and pre-authorization(s)
* List of current prescriptions and/or over-the-counter medication, including dose and frequency
* Information about patient's medical and surgical history
* Recent test results, x-rays, CT scans, or MRI scans: films, reports or relevant records

Download and bring the following New Patient Forms completed prior to your visit:
Acknowledgement of Receipt of Privacy Practices

1. Acknowledgement of Receipt of Privacy Practices
2. Consent for Use and Disclosure of Health Information
3. Financial Agreement
4. Patient History
5. Patient Information Sheet

Or please arrive early so that we can complete your initial paperwork.
Insurance and Payment Information
Dr. Mautner's is a provider for  Aetna, United, Avmed, JMH, Careplus, Blue Cross, Vista, medicare and most major insurance plans, and provides insurance billing. You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

Privacy Practices
Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available to download or available upon request.

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Healthcommunities.com, Inc., the publisher of neurologychannel, does not endorse specific organizations. Every effort has been made to ensure the accuracy of the following links, which are provided as a courtesy. If any information requires updating, please contact neurologychannel.
National Child Abuse Hotline
1.800.422.4453 - (1-800-4-A-Child)
The National Domestic Violence Hotline
1.800.799.7233 - (1-800-799-SAFE)
Poison Control
1.800.222.1222
National Suicide Prevention Lifeline
1.800.273.8255 - (1-800-273-TALK)
ADD Resources
Children and Adults with ADD (CHADD)
ALS Association
Alzheimer's Association
Alzheimer's Disease Education and Referral (ADEAR Center)
American Association for Geriatric Psychiatry
American Health Assistance Foundation
Consumer Consortium on Assisted Living
Eldercare Locator
Ethnic Elders Care
National Aphasia Association
National Ataxia Foundation (NFA)
Autism Research Institute
Growing Minds Autism Programs
Interactive Autism Network
The Son-Rise Program...The Autism Treatment Center Of America
Brain Injury Association Inc.
BlazeSports®
United Cerebral Palsy
Creutzfeldt-Jakob Disease Foundation, Inc.
Dystonia Medical Research Foundation (DMRF)
The Epilepsy Foundation
National Fibromyalgia Association
Guillain-Barre Syndrome Foundation International
American Council for Headache Education (ACHE)
National Headache Foundation
World Headache Alliance
Hemifacial Spasm Association
Caring For People with Huntington's Disease
Huntington's Disease Society of America
American Lyme Disease Foundation
Lyme Disease: A Patients Guide
Lyme Disease Info
Multiple Sclerosis Association of America (MSAA)
National Multiple Sclerosis Society
Movement Disorders
WE MOVE
Muscular Dystrophy Association
Myasthenia Gravis Foundation of America (MGF)
Neurofibromatosis, Inc.
The Children's Tumor Foundation
Charcot-Marie-Tooth Association
The Neuropathy Association
National Foundation for the Treatment of Pain
American Chronic Pain Association, Inc. (ACPA)
Spine Health
American Parkinson Disease Association
The Michael J. Fox Foundation for Parkinson's Research
National Parkinson Foundation, Inc.
Parkinson's Disease Foundation
Restless Legs Syndrome Foundation
National Spasmodic Dystonia Association (NSDA)
National Spasmodic Torticollis Association (NSTA)
Stem Cell Information
American Stroke Association
National Institute of Neurological Disorders and Stroke
National Stroke Association
Tourette Syndrome Association, Inc.
International Tremor Foundation
Tremor Action Network
Aging Parents and Elder Care
The Brain Matters
Christopher and Dana Reeve Paralysis Resource Center
Family Caregiver Alliance
The National Rehabilitation Information Center (NARIC)
OTCsafety.org: Safe & Effective OTC Medicine Use
Safe Medication