Patient Forms

For your convenience we've included many of the forms we'll need from you for your first visit. Please print out the appropriate forms and fill them out at your leisure. Simply bring them with you to your following visit.

New Patient Forms

• New Patient Information
• Consent for Use and Disclosure of Health Information
• Insurance Information

Informative Print-outs

• No Cavity Plan
• Outpatient General Anesthesia Versus In-Office Sedation
• Pit and Fissure Sealant Information
• Post-Extraction Instructions
• Space Maintainer Instructions
• Pre-Sedation Instructions
• Consent for Conscious Sedation

These forms require Adobe Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo above to download it.