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Patient Forms

 

Please print and complete the following forms and bring them with you to your first appointment

Patient Health History

Please print and complete both pages and bring them to your first appointment.

HIPPA Privacy Act

Please print, review, and sign the last page of the "Notice" document and bring it to your first appointment.

Print and complete the "Permission to Disclose" document if it applies to you.

Additional Forms

Please print and complete both forms prior to your first appointment.

Helpful Links

 

Below, you will find a few sites to help you stay current on the latest ways to keep your mouth healthy

American Dental Association

A useful resource to keep up on the latest news and developments in the world of dentistry

MouthHealthy.org

A great site for tips on keeping your mouth (and body) healthy at any age!

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