Patient Forms

If you are a new patient to our office, before your appointment, please fill out the New Patient Registration Packet (see the first link below). There are 4 forms to the New Patient Registration Packet.  In order to attend to your dental needs more efficiently and effectively, please complete the Packet and submit them electronically prior to your visit.  All information is HIPAA encrypted and securely stored. (As a note, make sure you allocate enough time to fill out all 4 forms of the package in one sitting because the information you enter does not get saved until submitted)  Thank you and please call our office if you have any questions.

New Patient Registration Packet (4 forms)

HIPAA Notice of Privacy Policies

Other Forms:

Registration/Insurance Update Form

Medical & Dental History Form

Financial Agreement Form

HIPAA Notice of Privacy Policies Patient Acknowledgment Form

Dental Records Release Form

COVID-19 Screening and Acknowledgment Form

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