Please print and fill out these forms so we can expedite your first visit:
- Patient Information Form
- Acknowledgement of Receipt of Notice of Privacy Rights
- Notice of Privacy Practices
- Facts you should know about Dental Insurance
- Financial Agreement
- Notice of Deemed Consent to HIV Testing
- Authorization to Release Information
- Authorization for Credit Card Payments
- Referral Questionaire
- Disclosure Notice
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
PLEASE TAKE YOUR REGULAR MEDICATION PRIOR TO ANY APPOINTMENT.
PLEASE MAKE SURE TO EAT EITHER BREAKFAST, LUNCH OR DINNER BEFORE YOUR SCHEDULED APPOINTMENT.
A parent or guardian must accompany all patients under 18 at the consultation visit.
Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)