New Patient Information Forms

Please complete our online forms below before your appointment. You can also download & print the forms by following the link below.

If you're not able to complete our forms online, please arrive at least 25-minutes early to allow time to complete the medical/dental health questionnaire and the patient information form. If you have a complicated health history, please mail it to our office so that we might review it in advance. Be sure to list all medications with dosages and any natural supplements, attaching an extra sheet if necessary.

  • Patient Registration Form
  • Patient HIPAA Consent Form

HIPAA & Privacy Policy

Notice of Privacy Practices presents the information that federal law requires us to give our patients regarding our privacy practices. This notice is a pdf document which requires the Adobe Reader software. You most likely already have this software on your computer. However, if you have difficulty reading the notice, please click here to install Acrobat Reader.

  • Infographic & General Fact Sheets
  • Online Video Library

Referring Doctors

General dentists and other doctors may refer patients to our office by filling out our secure Referral Form. After you have completed the form and set up your login information, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it. Please call our office to become a part of our referral program.

  • Review cases thoroughly in advance
  • Refer back to your office for restorations
  • Collaborate with you on treatment plans
  • Are available in an advisory role
  • Offer accommodating scheduling
  • Provide timely assessments and imaging

Patient Document & Form Download

We have made our patient forms and notices available for download. Printing out & completing the required forms ahead of time will expedite your visit with us. The following documents are available as printable PDF files using Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, download a free copy now from Adobe by clicking here.

error: No Right Clicks Allowed.