Getting Started As A New Patient In Our Office!

Congratulations! Welcome to our practice! We are very excited that you have chosen to be part of our dental family. Please fill out all forms below and bring them with you on your first dental appointment. The Notice of Privacy Act form is for your records only we do not need you to bring this form into the office.

If you are transferring from another office please fill out the form that is for x-ray transfer authorization and send this to your previous dental office so they can submit any and all x-rays that they may have on file; x-rays older then 1 year will be obsolete; if they are bitewings. However, if your previous dentist has a panoramic film or full mouth series on file; we will accept this x-ray because it is good for 3 years.

Now you can fill out all necessary forms prior to your visit online!  

Also, if you are a registered patient please login prior to your scheduled appointment and update your medical form.

Simply Click the Appropriate Link Below

EXISTING PATIENT LOGIN

NEW PATIENT FORMS

If you prefer to have a paper form please fill out the forms below and bring them with you to your scheduled appointment, Thank you.

New Patient Form

Insurance Disclaimer

Medical History Forms

Acknowledge Receipt NPP

Record Transfer Form

Financial Policy

HIPAA Release Form


Notice Of Privacy Practices
 – New revised version of the  HIPAA laws please
make a copy for your personal records