Patient Forms

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

Choose Online and Secure Option:

Your Online Patient Forms

Or print and bring with you:

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