Patient Registration & Forms

Please click on the links below to see downloadable Adobe PDF versions of our office forms. You most likely already have this software on your computer. If you have difficulty accessing these forms, please click here to install Acrobat Reader

Patient Registration Form/Health Questionnaire:
To expedite your initial appointment, please complete this form (along with a list of all medications you are currently taking) and bring it with you to our office. It is critical that this form be completed accurately to ensure that the Doctor and dental team are aware of all medical conditions prior to treatment.

Dr. Referral Slip:
Referring Doctors can download our referral slip to provide us with information about the patient and his or her dental condition.

HIPPA Privacy Policy:
This form presents the information that federal law requires us to give our patients regarding our privacy practices.

Patient Feedback Questionnaire:
We would appreciate your constructive feedback on the quality of services you received at our office.

Informed Consent Forms:
These forms explain what patients can expect during treatment as well as provide answers to the most commonly asked patient questions.

Permission to Use Full Face Images:
The Doctors are involved in providing continuing education to other dentists. The Doctors may request that you provide them with written permission to show your face in pictures presented in these clinical presentations. You are not obligated to provide this permission.