Patient Forms

Complete your forms before your visit to save time at your appointment

Download & Complete Your Forms

To help us provide you with the best possible care and make your visit more efficient, please print and complete the appropriate forms before your appointment. Download the forms, print them out, fill them in by hand, and bring the completed forms to your appointment.

Please DO NOT email forms.

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Patient Registration

Basic information about you, your contact details, insurance information, and emergency contacts.

Download Form
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Medical History

Important medical information, current medications, allergies, and health conditions that may affect your dental care.

Download Form
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Office Policy

Our office policies regarding appointments, payments, cancellations, and general practice information.

Download Form
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HIPAA Privacy Policy

Information about how we protect your health information and your rights regarding your medical records.

Download Form

Receipt of Policy Form

Acknowledgment that you have received and understand our office policies and privacy practices.

Download Form
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Notice of Privacy Practices

Our notice explaining how your personal health information may be used and your rights under federal privacy regulations.

Download Form

How to Complete Your Forms

1

Download

Click on the form links above to download the forms to your device.

2

Print & Fill Out

Print the forms and fill them out completely and accurately using a pen.

3

Bring to Appointment

Bring the completed printed forms with you to your appointment. Do not email forms.

Important Information

  • First-time patients: Please complete all forms before your first visit
  • Minors (under 18): Forms must be completed and signed by a parent or legal guardian
  • Insurance: Please bring your insurance cards to your appointment
  • Medications: Include ALL medications, including over-the-counter drugs and supplements
  • Updates: Please inform us of any changes to your medical history or medications

Need Help with Your Forms?

Our team is happy to assist you with any questions about completing your patient forms.

Please bring completed forms to your appointment. Do not email forms.