If you are a new patient, please fill out all three of these forms and bring them with you to our office. These forms can be filled out on your computer and then printed, or you can print them and fill them out by hand.
Thank you and please call our office if you have any questions.
Patient and Financial Information
Medical and Dental History
Consent to Office Policy and HIPAA
Authorization Release of Dental Records
Cracked Tooth Syndrome
Temporary Crown and Bridge Information
Occlusal Guard Instructions
Extractions Post Op Instructions
We accept most major PPO insurances. However, as an optimal-care dental practice, we strongly believe our patients deserve the best possible dental services we can provide. In an effort to maintain a high quality of care, we would like to share some facts about dental insurance with you.
Facts about Dental Insurance
Notice of Material Changes to Privacy Practices Policy
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.