Patient Forms

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

  • Patient Information Form (Child) PDF
  • Medical History (Child) PDF
  • Patient Form (Adult) PDF | DOC
  • COVID-19 Supplemental Health Questionnaire DOC
  • COVID-19 Supplemental Informed Consent DOC
  • Patient Acknowledgement of HIPAA PDF
  • Notice of Privacy Practices HIPAA PDF
  • Dental Material Fact Sheet PDF

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