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NEW PATIENTS

Patient Forms and Resources

Patient Forms

Our staff looks forward to meeting you and discussing your goals. We strive to keep our appointments on time as scheduled. Prior to your appointment, we encourage you to fill out the patient forms that are located on this website so you can accelerate your check-in process. Please access the forms that apply to you, and fill them out prior to your appointment. If you are unable to access our patient forms, then it is recommended that you arrive at your appointment 15 – 30 minutes early so you can have ample time to fill out the appropriate forms.

Printable and Online Forms

Privacy Form

1. Privacy Form

Patient Screening Form

2. COVID-19 Safety Screening

HIPAA Form

3. HIPAA Form

Patient Information Form

4. Patient Information Form

Patient History Form

5. Medical and Dental History Form

Patient Medical Update Form

6. Patient Medical Update Form

1. COVID-19 Safety Screening Checklist:

Online Form

2. Patient, General and Insurance Information:

Online Form

3. Medical and Dental History Form:

Online Form

4. Dental Implant Questionnaire:

Online Form

5. Invisalign Clear Aligner Orthodontic Therapy Questionnaire:

Online Form

6. Bad Breath, Oral Malodor, Halitosis Questionnaire:

Online Form

*Individual results are not guaranteed and may vary from person to person. Images may contain models.