Important Documents

NEW PATIENT FORMS – Please print and complete one form for each child. If you have more than one child coming to our office, you will only need to complete one Financial Agreement, General Patient Information and HIPAA Authorization Form for your family.

• Consent Form
• Financial Agreement
• Medical History
• General Patient Information
• HIPAA Authorization Form
• HIPAA Policy

 

ADDITIONAL FORMS:

• Additional Caregiver Consent– Please complete if there will be additional people bringing your children to their appointments
• Authorized Release of Information – Please complete this form when records should be transferred to or from another dental office