Patient Forms

Before you see a dentist or hygienist, we will need some information regarding your medical history and also information to set up your account.  It is important that the dentist be well informed of all medical conditions and medications you are currently taking before starting treatment.  We will periodically ask you to review and update this information to insure it is accurate.  IT IS ESPECIALLY IMPORTANT TO NOTIFY YOUR DENTIST OR HYGIENIST IF YOU HAVE HAD ANY JOINT REPLACEMENTS OR HEART CONDITIONS, YOU ARE TAKING BLOOD THINNERS, OR YOU ARE UNDERGOING CHEMOTHERAPY OR RADIATION TREATMENTS.
Please click  the files below to download our Patient Medical History and Patient Information forms.  You may fill these out prior to your appointment and bring them in with you.

Records Release Form (Please complete at least 2 weeks prior to your first visit and return to our office in order to have your current records transferred to our office in a timely manner)

Medical History Form

Patient Registration Form

Authorization and Consent to Treatment Form

HIPAA Acknowledgment Form

You may read our HIPAA Privacy Policy here.