Patient Forms

PatientFormsPhotoIn order to save you time, you can download our new patient forms and have them filled out before you come to your first visit. Please bring the following items with you to your first visit:

Adult New Patient Forms

  1. Adult New Patient Forms (Click to View & Print)
  2. HIPAA Form (Click to View & Print)
  3. Imaging Consent Form (Click to View & Print)
  4. Driver’s License
  5. Insurance Card, if you have dental insurance.

Child New Patient Forms

  1. Child New Patient Forms (Click to View & Print)
  2. HIPAA Form – signed by parent/guardian. (Click to View & Print)
  3. Imaging Consent Form (Click to View & Print)
  4. Parent/Guardian Driver’s License
  5. Insurance Card

To request a copy of your or your family medical records please download and complete a Patient Records Release Form.

To permit a minor to have follow-up dental treatment in the absence of a parent or guardian, please fill out the Parental Permission Form.

Please review the HIPAA Policy Form prior to completing the HIPPA Consent Form.