Forms

Registration Forms for Our Patients

We are providing these forms for our patients for their convenience. Forms may be printed out or filled in online. Online form information is encrypted, secure and HIPAA complaint.

If you want to download and print any of these forms to bring to your appointment, then you must  have Adobe reader or an equivalent PDF reader on your computer.

Please note, depending on how you computer is set up, the forms may end up in you download area, rather than in your browser.

 

New Patient Registration Form. Fill it out ONLINE, or PRINT IT  and bring it in with you. All information is encrypted through our secure server. If you have dental insurance, please bring your insurance card to your first appointment.

Medical History.   Fill it out ONLINE, encrypted and HIPAA secure. We will have you sign it when you come in. If you’re not comfortable filling the form online, then feel free to PRINT IT out, and bring it in with you.

Insurance Information    Best if you bring your card with you to the appointment

HIPAA Information Form   New patients will sign the form here at the office.

Appointment No Show Policy  If you can’t keep your appointment, we’d like to know about it beforehand. It helps us provide better care for everyone, especially when emergency patients call!