To save time on your office visit, we offer the following forms which may be filled out prior to your appointment. The forms are presented as PDF (Portable Document Format) files. To view/print the PDF files, you must have Adobe Reader installed on your PC/laptop. Adobe Reader is a free document viewer which is available for download at:

             www.adobe.com

NOTE: The PDF files allow you to fill out the form fields and print the forms with the content you entered. PLEASE BE AWARE that you cannot save the results of your entries. This feature IS NOT supported within Adobe Reader. With this being said, be sure all you entries are correct and you have printed the forms before closing the Reader application. (You are not obligated to fill out the forms via your PC/laptop. You can always go "Old School" and use a pencil or pen).

• New Patient Forms
  This PDF document includes:
  • Includes Medical History Form
  • Patient Data Sheet Form
  • Patient Insurance Form
  • DentalFx Policies
  • Notice of Privacy Practices Statement
  • Acknowledgement of Receipt Form of Notice of Privacy Practices Statement
  • Consent & Release for Use and Disclosure of Health Information Form
    
    
• Oral Screening Consent Form
• Oral Surgery Medical Patient Forms