Forms

We are happy to offer our forms and applications for download.  Please feel free to print these and fill them out at your convenience before your visit.  Please do not email these forms over the Internet.

Registration & Health History

This form needs to be filled out before your first dental appointment.
Click here to download (1.2 MB)

Notice of Privacy Practices

This document is for your general information as required by federal HIPAA laws.
Click here to download (1.9 MB)

HIPAA Form

This form acknowledges that you have read the "Notice of Privacy Practices" above.
Click here to download (235 KB)

Consent for Disclosure of Health Information

This form needs to be filled out before your first dental appointment.
Click here to download (639 KB)

Office Policies

This form needs to be filled out before your first dental appointment.
Click here to download (881 KB)

Getting to Know You

This form will help us serve your specific dental needs.
Click here to download (495 KB)

 
If you are unable to view the pdf files, please click on the icon below to download and install Adobe Reader: