New Patients

1. You may fill them out on your computer using your keyboard and mouse, and print them. Once printed, you may fax or mail them to us (see Contact Us) or you may bring them with you to your appointment.
      
2. You may print the forms and fill them in with a pen. Once complete, you may fax or mail them to us (see Contact Us) or you may bring them with you to your appointment.

• Child forms should be used for any patient younger than 12 years of age.
• When filling out the medical and dental history forms, please use the space to the right of the question to explain any question to which the answer is "YES."

Please use the forms below to update us on changes of which we need to be aware. You may fill out the form on your computer using your keyboard and mouse, and print the completed form, or print a blank form and fill it in with a pen. Once finished, you can fax or mail the form (see Contact Us) to us or you may bring it to your appointment.

• Patient Records Request Form - to have records, x-rays, photos sent to us from a former dentist.
          
• Photographic Release Form - permission to use images of a patient where the patient can not be identified (i.e. - photos of teeth, x-ray images, etc.).
        
• Identifiable Photographic Release Form - permission to use images of a patient where the patient may be identified by others (i.e. - a full face photo).

You will need Adobe Acrobat Reader to view our forms, which is a free software available by clicking the Adobe Reader logo below.