Patient Forms

New Dental Patient Forms

New patients can complete these dental new patient forms in a three step process: simply download, print and fill them out prior to your first appointment. They’re available online, you can click on each form below to gain access and begin downloading the PDF version. 

We recommend completing these in advance because you can look up any necessary information ahead of time, verify its accuracy, and fill it out in the comfort of your own home.


Completing the Forms in Advance

The purpose of these documents is to communicate and inform you of your rights as a patient. You can read an overview of what is covered within each form below:

New Patient Registration

With this form, you authorize that the information is given to the best of your knowledge and that you understand the responsibility of payment for services rendered. This information allows us to provide the most effective care. The new patient form covers:

  • Identifiable patient information
  • Emergency contacts
  • Insurance provider
  • Medical and dental history
  • Practice Policies

HIPAA Communication Form

This form informs you of your rights to private and protected health information under HIPAA. Our practice will not disclose confidential information without your consent or written authorization unless otherwise required by federal or state privacy laws. The HIPAA communication form includes:

  • Provided Notice of Information and Privacy Practices
  • Preference for communications of health care information

Your First Appointment

When you come in for your appointment, make sure to bring these dental office patient forms along with your photo identification, insurance card, and a method of payment for any copays or out-of-pocket costs due at time of service. We ask that you arrive ten minutes early to get settled before your visit. 


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