Patient Registration Forms

If you are a new patient or haven’t had the opportunity to visit us in the last year please plan to come to your appointment 20 minutes early to fill out and update your patient registration, health history, and financial policy forms; or, for your convenience, you may print the forms below, fill them out completely, and bring them with you to your appointment.

• Adult Patient Registration Form
• Child’s Registration Form (for children younger than 13 years old)
• Health History
• Financial Policy
• HIPAA Notice of Privacy Practices for your own records
• Acknowledgement of Receipt of Privacy Practices to sign and bring with you

If you are coming to see us but have recent x-rays from another dentist you may either bring those x-rays with you or fill out and send the records release to your previous dentist.