On this page, you'll find forms both necessary and helpful regarding your visit to our office.
HIPPA Notice of Privacy Practices- This notice describes how health information about you may be disclosed and how you can get access to this information.
New Patient Questionnaire and Medical History- Required for all new patients or patients returning to our office after an extended absence (over two years).
Medical History Update- Existing patients to update yearly.
Record Release- signed document to transfer x-rays out of office.
Consent for Treatment of Unaccompanied Minors- In the event that you can not bring your (minor) child to his/her appointment, the following form must be filled out and signed before the appointment.
Doctor's Referral Form - Doctors can complete the form on their computer, print, sign & mail it to our office. As always we appreciate the confidence you have in our practice!
Understanding your Benefits - Educational tool for patients to help with the understanding of insurance benefits.
Roxanna greeted me right on time and made me feel very comfortable in her chair. Dr.Stern spent time checking my teeth and explaining my options. Very comfortable visit. Always a great relaxing experience.
As I stated earlier, I've never received this kind of cleaning in my life, and I'm 53 years old. Fabiola has improved the appearance of my teeth tenfold! I've even added an extra cleaning annually at my own expense. She's so unbelievably thorough. She even told me about a great toothpaste that is good for my teeth (I have bonding) and they were yellowing. I was so self-conscious, I wouldn't smile. Now I don't have any yellow anywhere! She also easily explained where some pain in my mouth was coming from, so it actually hurts less now that I know it isn't serious or worrisome. Fabiola is friendly and the most terrific hygienist I've even come into contact with. I can't wait to my next appointment and yes, I have recommended your practice many times! My daughter asked me if I had my teeth whitened after my last cleaning. If that isn't the biggest compliment ??!!
Mary Ann M.
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