Patient
Forms
Health Forms
The following forms can be viewed using Adobe Acrobat Reader (.pdf files).
Click on the form link below to view and print the forms:
Health Forms
The following forms can be viewed using Adobe Acrobat Reader (.pdf files).
Click on the form link below to view and print the forms:
Registration and Health
Please print, complete, and bring these forms to your first appointment. They include a Confidential Registration Form, Confidential Health Questionnaire Form, and a HIPAA Privacy Acknowledgement Form.
Privacy Notice
The Privacy Notice is provided for you to review. It explains how we care for and protect your confidential health information.
Payment Information
Our Insurance and Payment information explains how we handle your dental insurance if you have insurance and our payment guidelines for any balance of the fees that you may owe.
X-Ray Transfer
Send this form to your previous dentist’s office authorizing them to send your x-rays to our office.
Registration and Health
Please print, complete, and bring these forms to your first appointment. They include a Confidential Registration Form, Confidential Health Questionnaire Form, and a HIPAA Privacy Acknowledgement Form.
Privacy Notice
The Privacy Notice is provided for you to review. It explains how we care for and protect your confidential health information.
Payment Information
Our Insurance and Payment information explains how we handle your dental insurance if you have insurance and our payment guidelines for any balance of the fees that you may owe.
X-Ray Transfer
Send this form to your previous dentist’s office authorizing them to send your x-rays to our office.