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Patients

Patient Forms

Forms You Can Complete From Home

To continue making your dental experience pleasant, we have conveniently provided our dental forms below, so that you can fill them out in the comfort of your home and bring them into the office with you.

Available Forms

Click any form below to fill it out online or download a printable PDF. If you have questions about which forms apply to your visit, please contact our office.

Online Form

Health History Form

Complete your medical and dental history online before your visit.

PDF Download

HIPAA Consent

Acknowledge our privacy practices, as required by HIPAA.

PDF Download

Insurance Assignment & Release (Adult)

Authorize us to file insurance claims on your behalf for adult treatment.

PDF Download

Insurance Assignment & Release (Pediatric)

Authorize us to file insurance claims on your behalf for your child's treatment.

PDF Download

Pediatric New Patient Form

Complete your child's medical and dental history before their first visit.

PDF Download

How Did You Hear About Us?

Help us understand how you found our practice.

PDF Download

Bisphosphonate Therapy Waiver

Required for patients currently or previously taking bisphosphonate medications, such as Fosamax, Boniva, or Reclast.

Need Help?

Forms can be downloaded, printed, and brought to your appointment, or completed at the front desk when you arrive. If you have questions about which forms apply to your visit, please contact us.

Helpful Resources for New Patients

Ready to Schedule? We're Here to Help.

Forms in hand, give us a call or request your appointment online. New and returning patients welcome.