PATIENT FORMS

New Patient Form Adult 18 and Older

  • Click here ELECTRONIC to fill out all New Adult Patient Forms online via your desktop, cell phone, or tablet!

Below is a list of New Patient Forms for you to print and bring with you to our office.  

  • Adult Patient Form (PDF
  • Notice of Privacy Practice Acknowledgement (PDF)
  • Cancellation Policy (PDF)

Below is a copy of our HIPPA policy to print and keep for your records. 

  • Notice of Privacy Practices (PDF)

New Patient Child

  • Click here ELECTRONIC to fill out all New Patient Child Forms online via your desktop, cell phone or tablet!

Below is a list of New Patient Forms for you to print and bring with you to our office.

  • Child Patient Form (PDF) | 
  • Notice of Privacy Practices Acknowledgement (PDF)
  • Cancellation Policy (PDF)

Below is a copy of our HIPPA policy to print and keep for your records. 

  • Notice of Privacy Practices (PDF)

COVID-19 Forms

  • Covid - 19 Pandemic Dental Treatment Notice and Acknowledgement of Risk (PDF) | (ELECTRONIC)


Miscellaneous Forms

  • Authorization to Charge Credit Card (PDF)


Welcome Back Patients

  • Welcome Back! Adult Patient Form (PDF)
  • Welcome Back! Child Patient Form (PDF)

Office Hours

Monday:

8:00 am - 5:00 pm

EVERY OTHER

Tuesday:

8:00 am-12:00 pm

1:00 pm-5:00 pm

Wednesday:

8:00 am-12:00 pm

1:00 pm-6:00 pm

Thursday:

8:00 am-12:00 pm

1:00 pm-5:00 pm

Friday:

8:00 am - 5:00 pm

EVERY OTHER

Saturday:

Closed

Sunday:

Closed

Contact Us Today!

We look forward to hearing from you.