Now you can complete the necessary information at your leisure. The Patient Registration/ Health History Form is an electronic form that you can submit at the end.
--Patient Registration/ Health History Form
Click to print the forms below.
--Electronic Funds Transfer Form
--Dental/Orthodontic Insurance Information Form--Insurance Reimbursement Tracking Form
-- HIPPA Notice of Privacy Practices
--HIPPA Notice of Privacy Practices Acknowledgement
If you need help filling out the forms, just call us or let us know when you arrive for your appointment.
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
What does your smile say about you? Let us help you radiate confidence with a healthy smile.