Forms

To expedite our New Patient process, please:

• Download ALL (6) forms below
• Fill them out as completely as you can
• Bring them with you to your first appointment.

For your convenience, all  forms are available in both
Word and pdf formats


1. Patient Registration   pdf    Word

2. Authorization to Release Health Care Information  pdf    Word

3. Dental/Medical History   pdf    Word

4. HIPAA Letter   pdf    Word

5. HIPAA Acknowledgement   pdf    Word

6. Patient Disclosure  pdf    Word