New Patient Forms

If you're a new client, please complete the following form and bring it to your first visit to our dentist office.

• New Patient Form
• Agreement to Pay for Treatment Form
• Dental History Form
• Medical History Form

If you would like us to coordinate with another dental clinic to request x-rays, please complete this form:

• X-Ray Release Form
• HIPAA Authorization Form

Note: To download Adobe Acrobat Reader for free, click here