accessibility ACCESSIBILITY
Patient Forms

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 for patients returning to our office after an extended absence (over two years). 

You may complete it on your computer then print it out, or you can print it then fill it in manually.  Please bring the forms with you to your appointment. 

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 prior to the appointment.   

Doctor's Referral Form - Doctors can complete the form on their computer, print, sign & mail to our office.  As always we appreciate the confidence you have in our practice!

Understanding your Benefits - Educational tool for patients to help with understanding of insurance benefits.  

Smile Analysis


The new patient intake forms require Adobe Reader.  

If you don't already have it installed you can download it below.  

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