Patient Forms

Patient Information and Health History Form

and

HIPAA Consent Form:

Patient Information and Health History Form

HIPAA Consent Form 

HIPAA -Notice of Privacy Practices Word Doc (to read only)

Dental Insurance Questionnaire and

Consent Authorization Form:

 Dental Insurance Questionnaire and Consent Authorization Form

To Make a Payment on your Account:
 

Payment Authorization Form

Transfer Out Consent Form:

Transfer Out Consent Form