Dental Plan Registration

Begin your dental plan registration by filling out the form below.

Once completed, you will finish your registration at the office where someone will help you choose the plan right for you, and your billing will start.

D.E.N.T.A.L. Study Group - Buffalo WNY AADOM Chapter

You will choose one of these dental plans when you finish your registration in the office.

Plan Name Monthly Yearly

Regular Membership

One Year membership for in person meetings. • Three formal meetings with guest speakers who are experts in their field (Management and Dental related topics) • Three Manager to Manager meetings. • Continuing education credits toward FAADOM (some seminars may qualify for AGD CE credits). • The opportunity to connect with, and learn from, other office manager professionals in the Buffalo area. • Access to the most up-to-date changes in the dental field. • Access to local and national sponsors that support continuing education and training. 		$100.00/ yr

Virtual Membership

One Year Membership for Virtual Meetings - All benefits from Regular Membership included with virtual access via Zoom meeting. - One in person meeting included . ** Virtual membership eligibility is limited to those who live 60 miles or more from 300 Corporate Parkway, Amherst, NY 14226 		$75.00/ yr

Early Bird Regular Membership

All benefits of Regular Membership listed above discounted if paid by August 15th. One Year membership for in person meetings. • Three formal meetings with guest speakers who are experts in their field (Management and Dental related topics) • Three Manager to Manager meetings. • Continuing education credits toward FAADOM (some seminars may qualify for AGD CE credits). • The opportunity to connect with, and learn from, other office manager professionals in the Buffalo area. • Access to the most up-to-date changes in the dental field. • Access to local and national sponsors that support continuing education and training. 		$90.00/ yr

Buffalo/WNY AADOM Board Member

This is only for board members of the Buffalo/WNY AADOM Chapter 		$0.00/ yr

Dental Plan Members

Who is signing up for a dental plan? We only need basic information for now; you will choose a plan for each member and begin your billing when you visit our office.

Members

First Name * Last Name * Date of Birth *

Billing Details

Once your registration is complete and your plan is approved, how would you like to be billed?

Note: This card WILL NOT be charged until you visit the office to select a dental plan and finalize your registration. We collect this information now to speed things up during your first appointment!

Credit Card Information

This card will be used for all members associated to this responsible party.

Card Number
Please enter a valid Credit Card number
Expiration (mm yy) Example: 06 27

Ready to submit?

Please Correct all errors marked in red in your registration information and submit again

When you’re finished, click the button below to submit your information. You will not be billed until you choose a plan and finalize your registration at our office.