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David K. Hansen, DMD 204 E. 400 N. Suite A Salem, UT 84653 801-423-0905 www.WoodlandDental.netWoodland Dental 2009 - 2010Membership Discount PlanYearly Fee:Individual: $150 ($439 value)Each additional family member: $75 Member- ship (additional family members are those living in the same household)Discount Includes:• 2 cleanings per year (comprehensive exam, prophylaxis, panoramic x-ray (if indicated), bitewing x-rays and fluoride)• All other services will be given a 20% membership discount (Excluding Invis- align, a 10% discount will be applied on Invsisalign)Benefits of the Discount Plan:• All dental services at discounted rates• Both 6 month cleanings and exams for less than the price of one• No preauthorization needed• No waiting periods or exclusions for pre- existing conditions• No deductible• No age limitAdditional Terms and Conditions:• Once a family member is added, they can’t be substituted by another family member.• A family member can be added anytime during the year, the ended coverage date will remain the same.• Cleanings must be done before the ending coverage date.• This discount plan cannot be used in con- junction with any other insurance.• If upon initial exam, you are diagnosed with periodontal disease, four deep clean- ing (SRP) appointments will be neces- sary for treatment. Patient will receive a 20% discount on these appointments. To prevent periodontal disease from becom- ing worse, patient will need four cleanings a year called “perio maintenance”. Each year the patient signs up for the discount plan, the patient will pay for the 1st and 2nd perio maintenance appointments with a 20% discount. After patient pays for 2 perio maintenance visits within the year the patient will receive the final two perio maintenance visits at no charge.For additional information or to sign up on the Woodland Dental Membership Discount plan, please contact our office at 801- 423-0905.All fees, discounts, benefits, terms and conditions subject to change without notice.