We’ve put all of our common forms that patients fill out in the office here online.  Just click the download button to download the appropriate form in the PDF format.  (You may need Adobe Reader to view and print the PDF files, if you don’t have Adobe Reader you can download it for free by clicking here)

New Patient Information Form

This form is for all new patients.  If it’s your first time to our office, simply download this form, print, fill out, and bring with your during your visit.  It will save you time when you come in. Let us know if you have any questions about the form.

Medical History Form

Before your first visit it’s important that we get your medical history.  Please fill out the form below and send it prior to your appointment or bring it with you to your first appointment.

Insurance Info Form

Do you have dental insurance?  If so, fill out this form and bring it with you to your appointment and we’ll be sure to do our best to bill them for your appointment.

Financial Agreement Form

This document is our standard agreement for patients to sign before we do any dental treatment.  Please download, print, sign, and bring it with you to your appointment.  Thanks.

HIPPA Form

This notice describes how health information about you may be used and disclosed and how you can get access to this information.  Please review it carefully.  The privacy of your health information is very important to us.

Autism Form

Our autism form is a way to help those with Autism to help them feel more comfortable at our office by knowing a few things about them.  Fill out this form and send to us and we’ll be sure to make your visit as comfortable as possible.

Insurance Release Form

This document is our standard insurance release form for patients to sign before we do any dental treatment.  Please download, print, sign, and bring it with you to your appointment.  Thanks.