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 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



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Windsor Dental Center
Steven P. Stern, D.M.D.
Aesthetic, Implant & Family Dentistry

Dr. Steven Stern of Windsor Dental Center is a professional dedicated to Excellence in General, Family, & Cosmetic Dentistry such as Dental Makeovers, Porcelain Veneers, Teeth Whitening, Crowns/Caps & many other dental procedures. Please come and visit Windsor Dental Center, in New Windsor, NY.


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