PATIENT FORMS AND INFORMATION
Patient information forms are available for download below.
Your initial appointment will consist of a thorough examination. Radiographs are necessary for a thorough and accurate diagnosis. If you have recent radiographs from a previous dentist please request that they be sent to our dental office prior to your visit.
During your visit we will review your medical history, examine your x-rays, teeth, gums, jaw alignment and provide an oral cancer screening. If you require antibiotic prophylaxis for any medical condition (i.e. total joint replacement, prosthetic heart valve etc.) please take the appropriate dose prior to your initial dental appointment. Depending on the health of your gums, a dental cleaning with our hygienist may be completed.
New Patient Forms
Please print and complete the following six forms: Patient Registration, Dental and Medical Form (2 pages), Financial Policy, Consent for Use of Disclosure of Health Information, and Acknowledgement of Receipt of Notice of Privacy Practices. Bring your completed forms to our office for your initial visit.
If you would like to review our Notice of Privacy Practice (HIPPA), please select "Notice of Privacy Practice" below. This form does not need to be printed and is available for your review.
As a courtesy to our patients with dental insurance we file insurance claims from our office. To allow us to provide you with accurate information about your insurance benefits please bring your insurance information as well as picture ID to your visit.