Patient Forms

Patient Forms

Please print and fill out these forms so we can expedite your first visit:

New Patient Medical History

Family Account Information form

If you would like us to request records from another dentist, please complete the Records Release Authorization Form below and fax it to your child’s previous dentist, so they can have the records to our office by your child’s appointment time.

Records Release Authorization Form

Notice of Privacy Practices

In order to view and fill forms, please download the most recent version of Adobe Reader.

 

Forms