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.
Smile Analysis