Paperwork

Please take a minute to print and fill out the patient information forms before your first appointment:

New Patient Forms

  • Patient Information Form | PDF
  • Medical History Form | PDF
  • Insurance Form | PDF
  • Acknowledgement of Receipt of HIPAA Policies and Procedures | PDF
  • Notice of Privacy Practices | PDF
  • Orthominder Form | DOC

CBCT Form

  • X-ray CBCT Information Form | DOC

Release for Minors

  • Release of Information for Minors | DOC

 

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Smile!