New Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

  • Patient Information Form PDF
  • Medical History Form PDF
  • Dental History Form PDF
  • Payment Policy PDF
  • Request for Use and Disclosure PDF
  • Request for Release of Records PDF

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

American Dental AssociationAcademy Of General Dentistry