Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

  • New Patient Information Form  PDF
  • Medical History  PDF
  • Insurance Information  PDF
  • Dental Records Release Form  PDF
  • Notice of Privacy Practices PDF
  • Acknowledgement of Receipt of Notice of Privacy Practices and Consent to Treat PDF
  • Referall Form PDF
  • Tooth Fairy Coloring Contest PDF

If you’re unable to open PDF files, you can get Adobe Reader® for free.

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