Patient Forms

Please complete the below online form prior to any appointment. Existing patients only need to fill out our COVID-19 Health Screening and Patient Information sections. New patients, please complete the entire form.

Online Patient Forms/COVID-19 Health Screening

Printable New Patient Forms:

  • Patient Form [PDF]
  • Dental History [PDF]
  • Medical History [PDF]
  • HIPAA Privacy Forms [PDF
  • Patient Screening PDF 

If you’re unable to open PDF files, you can get Adobe Reader® for free.

The place where you’ll find the rare combination of mercury-safe and superior dental care in a comfortable and service-oriented environment.You’ll love your smile ...guaranteed!