Patient Forms
Please take a minute to print and fill out the patient information form before your first appointment:
- Medical History 8 years old and younger- PDF
- Medical History 9 years old and older- PDF
- Registration Form - PDF
- Office and Financial Policy - PDF
- HIPPA Notice of Privacy Practices - PDF
- Authorization for Minor Child Accompany - PDF
- Credit Card Authorization Form - PDF
- Frenectomy - PDF
- Pre Treatment Instructions- PDF
- Post Treatment Instructions: Extractions- PDF
- Post Treatment Instructions: Frenectomy- PDF
- Post Treatment Instructions: Fillings- PDF
- Social Media Consent Form - PDF
- New Patient Introduction Packet - PDF
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