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New Patient Forms

Contact Us!

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

 
 

Welcome New Patients

To be ready for your first appointment please follow these steps:

1. Print and fill out "Patient Registration" form (If there is any information you do not know, leave it blank and we will be happy to help you complete it)

2. Print and review "Summary of Our Privacy Practices" and fill out the last page.

3. Print out "Patient Acknowledgments" and initial and sign on page 2.

4. Download a copy of the "Facts about Fillings Brochure" and review. This is for your records, there is no need to bring it in with you to your appointment.

Patient Registration - English
    
Patient Registration - Spanish

Summary of Our Privacy Practices 

Patient Acknowledgements 

Facts about Fillings Brochure 

Facts about Fillings (Spanish) 

 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.