Patient Information

Patient Medical History Form

You can fill in the information by typing on the lines, checking the boxes, then printing it out. Or, you can print it out and fill it in by hand. Then bring in this form and the HIPAA form below to speed up your registration.

HIPAA Privacy Form

Download this form, print it out, and sign the necessary lines. If you have any dental insurance benefit, don’t forget to bring that information with you also. This will ensure an efficient registration.

Post-Operative Instructions for Tooth Extraction

If you or a family member has had a tooth removed, please follow this form’s instructions for optimum healing.

Teeth Whitening Instructions

If you or a family member has received an Opalescence tooth whitening kit from our office, please follow these instructions for its use.

Post-Operative Instructions for Fillings

If you or a family member has recently received one or more fillings at our office, please follow these instructions to ensure proper healing.

Post-Operative Instructions for Scaling and Root Planing (Deep Cleaning)

If you or a family member has recently had a deep cleaning at our office, please follow these instructions to ensure proper healing.

Post-Operative Instructions for Root Canals

If you or a family member has recently received a root canal at our office, please follow these instructions to ensure proper healing.

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