accessibility ACCESSIBILITY

Please feel free to fill out your new patient paperwork before you arrive to our office.

These three links show the forms that need to be completed before we see you for your consultation. Please print the following forms below: New Patient Forms, Advance Notice for Cancellation Agreement and Privacy Agreement Form.

 If you choose not to complete these forms until you arrive, we ask that you arrive 30 minutes early in order to keep our schedule on time for all of our patients.

 

Patient Information/Health History Form

In preparation for your visit to our practice, please complete the following forms prior to your first visit. If you choose not to complete this form until you arrive, we ask that you arrive 30 minutes early in order to keep our schedule on time for all of our patients. 

New Patient Forms

Patient 48-hour Notice Cancellation Policy Form

You are important to us and so is your time that you've committed to visiting our practice to deal with your dental care needs.  We have set aside time just for you.  The same is true for each and every one of our patients.  In an effort to be respectful of your time and every patient’s time, we ask that you review and sign our appointment cancellation policy and bring it with you to your appointment.  We also ask that you arrive on time for your appointment so that subsequent patients will not be affected.  Thank you for your cooperation in this matter.

Advance Notice for Cancellation Agreement

HIPAA Policy/HIPAA Agreement

As required by law, you can review our Privacy Practices at the link below and please download and sign the Privacy Agreement form and bring with you to your appointment.  Please list anyone that you wish for us to be able to share your healthcare information with (i.e., spouses, children, etc.), for without their name listed we cannot do so.

Privacy Practices

Privacy Agreement Form

 

Thank you for taking the time, in advance, to prepare for your visit to our practice.

It will help your visit take less time out of your day. We look forward to seeing you!

(501) 319-7520