Forms

You may access the following forms to assist us with your care. Please print and complete the following forms, and bring them to your appointment.

• New Patient Welcome Letter
• Patient Registration
• Authorization to Release Dental Records
• Acknowledgement of Receipt of Notice of Privacy Practices - HIPAA
• School Dental Health Certificate
• Child Health/Dental History
• Dental History Form
• Medical History Form
• Financial Policy Form

*These forms require Adobe Acrobat Reader. Click the Adobe logo to download.