Patient Information, Brockton, MA

Patient Information

We are currently accepting new patients at Southeastern Oral & Maxillofacial Surgeons. We are proud to work with patients of all ages in Brockton, MA and surrounding areas, offering a wide range of surgical procedures to help them achieve healthier and more functional smiles. Dr. Coyne a

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Five Things You Need For Your Appointment

1. If you have a dentist, you must bring the referral with you.

2. If you take medications, you must bring a list of your medications and your medical history.

3. If you don’t speak English, you must bring an interpreter with you who is 18 years or older

4. If you have insurance, you must bring the dental and/or medical cards with you.

5. If we don’t have the required information, we will have to change or cancel your appointment.


Patient Form

Please download, print and fill out the form below and bring it with you to your first appointment. We also ask that you please print and fill out the COVID-19 Patient Form prior your office visit to encourage a prompt check-in process. Please contact our office with any questions on this form and we will be happy to assist you!

All Patient Forms


Please call our office at 508-588-0200 to schedule an appointment. Emergencies are seen on the same day whenever possible. If you need to cancel an appointment, please provide 24-hours notice, so that we can offer this time to another patient. If you do not provide 24-hours notice, you may be charged an extra fee.


Our team will submit your insurance claims so you can receive your maximum benefits. Our goal is to work with you so you can afford the treatment you deserve. For patients needing extensive work, we create a payment plan and schedule. We also accept CareCredit, a healthcare financing credit card.

Payment Options

Our practice accepts cash, check, and major credit card. We ask for payment to be provided before beginning treatment.

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For any questions about our practice or to schedule an appointment, contact us today at 508-588-0200. A member of our team will be happy to help you!