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PATIENT INFORMATION & RESOURCES

Patient Registration Form
Mountaineer Oral & Maxillofacial Surgeons office sign in Charleston and Ripley WV


At Mountaineer Oral & Maxillofacial Surgeons, we are committed to providing advanced surgical care with a focus on patient comfort, safety, and exceptional outcomes. Serving patients throughout Charleston and Ripley, WV, our experienced team specializes in diagnosing and treating conditions involving the mouth, teeth, jaws, and facial structures.

Oral and Maxillofacial Surgery requires extensive additional training beyond dental school, including hospital-based surgical and anesthesia education. As Board Certified Oral and Maxillofacial Surgeons, Dr. Byron Black and Dr. William Black provide comprehensive surgical care ranging from dental implant placement and wisdom tooth removal to corrective jaw surgery and facial reconstruction.

Our practice also offers advanced techniques designed to restore bone structure, reduce surgical intervention when possible, and improve patient comfort throughout treatment. We diagnose and treat a wide range of conditions, including facial pain, facial injuries, fractures, and other complex oral and maxillofacial concerns.


Surgical Staff

Our highly trained surgical staff includes experienced oral and maxillofacial surgical assistants and registered nurses who assist with procedures, intravenous (IV) sedation, and outpatient anesthesia. Every member of our team is dedicated to providing a safe and comfortable surgical experience.

Our administrative staff is knowledgeable in healthcare policies and insurance procedures, helping patients navigate their treatment experience from consultation through recovery. Our clinical team maintains current certifications in CPR, ACLS, and PALS.


Your First Visit

Your first appointment will include a comprehensive consultation where we will discuss your diagnosis, treatment options, and any questions you may have. In some cases, treatment may be performed on the same day as your consultation. However, more complex medical histories or surgical plans may require additional evaluation before treatment.

Please bring the following information to your consultation:

  • Your surgical referral slip and any available X-rays or imaging.
  • A current list of all medications you are taking.
  • Your completed insurance forms and current insurance information.

Patients under the age of 18 must be accompanied by a parent or legal guardian at their consultation appointment.

Patients receiving IV anesthesia must complete a preoperative consultation and physical evaluation before surgery. Please do not eat or drink for eight hours before your procedure unless otherwise instructed. An adult driver must be available to take you home following surgery.

Please notify our office before surgery if you have any medical conditions that may affect treatment, including diabetes, high blood pressure, artificial heart valves or joints, rheumatic fever, or if you take medications such as blood thinners, aspirin, or heart medications.


X-Rays and Imaging

If your dentist or physician has taken X-rays or other diagnostic images, you may request that they forward them to our office before your appointment. If there is not enough time, please bring copies with you. Additional imaging can be completed at our office if needed.


Scheduling & Appointments

Our office is open Monday through Thursday from 7:00 AM to 4:00 PM and Friday from 7:00 AM to 12:00 PM. Surgical procedures are scheduled throughout the week with both Dr. Black and Dr. Black.

If you have an urgent dental or facial concern, we will make every effort to see you as quickly as possible when your referring provider determines immediate care is needed. If we are unable to provide treatment at that time, we will help coordinate care with another qualified oral and maxillofacial specialist.

We strive to maintain an efficient schedule while providing every patient with the attention they deserve. Because our surgeons perform a wide range of procedures, including complex surgical cases and emergency treatments, appointment times may occasionally vary. We appreciate your patience and understanding.


Patient Registration

To make your visit more convenient, we encourage patients to complete our secure online Patient Registration Form before arriving at our office. Once completed, please submit the form using the "Complete and Send" button.

Protecting your personal information is one of our highest priorities. We take extensive precautions to maintain the security and privacy of your health information.

Please remember to bring all current insurance cards to every appointment. Missing insurance documentation may require your appointment to be rescheduled.

Patient Registration Form

Insurance Information

At Mountaineer Oral & Maxillofacial Surgeons, we work with our patients to help maximize available insurance benefits and make treatment as convenient as possible. Our knowledgeable team is available to answer questions regarding insurance coverage, claims, and payment options.

Please bring your updated insurance information to your first visit. If you do not have a copy of your insurance card, contact your employer’s HR department or insurance provider before your appointment.


Patient Privacy Policy

We respect your privacy and are committed to protecting your personal health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

Your protected health information may be used and disclosed as necessary for treatment, payment processing, and healthcare operations. Patients have the right to review our Notice of Privacy Practices, request restrictions regarding certain disclosures, and revoke authorization in writing when applicable.


Financial Information

Payment is due at the time services are provided unless prior financial arrangements have been made. For your convenience, we accept Visa, MasterCard, Discover, American Express, and CareCredit.

Patients are responsible for all charges incurred, regardless of insurance coverage. Insurance companies typically process claims within several weeks. Any remaining balance after insurance payments have been applied is the responsibility of the patient.

If you have questions regarding your account or would like to discuss payment options, please contact our office. Payment arrangements must be established before treatment begins.