Patient Forms

We realize that it's hard to fit appointments into your busy schedule.  You may need to squeeze in your appointment during a lunch hour, before work or before the kids get home from school.

For your convenience we have provided many of our forms on our web site.  If you wish, you may download, print and complete these forms prior to your first appointment.  This will give you time to prepare ahead and save you wait time.  In addition, we find our patients can provide more complete information when they have access to information from home.

Please remember to bring all insurance cards (both dental and medical) with you to your appointment.

Forms are provided in Adobe PDF format.

Acrobat-logo New Patient Registration Form (English)
Acrobat-logo Nuevo boletín de inscripción paciente (Spanish)
Acrobat-logo Medical History Form (English)
Acrobat-logo Forma del historial médico (Spanish)
 

HIPPA Forms
Acrobat-logo Notice of Privacy Practices (English)
Acrobat-logo Aviso de las prácticas de privacidad (Spanish)
Acrobat-logo Acknowledgment of Receipt of Notice of Privacy Practices (English)
Acrobat-logo Acuse de recibo del aviso de las prácticas de la aislamiento (Spanish)