Welcome to our practice!
During your first appointment we will register you as a patient by inputting your personal and insurance information in our system. The doctor will then discuss your background medical information and review the referral information sent by your referring dentist.
Please complete the following information so that we may begin to set up your profile before you arrive.
Some Windows based browser users may experience a problem when sending the form. If this happens to you don't worry - you can either email us your information directly to email@example.com, or you may provide us with your information when you arrive at the office.
If you have secondary insurance please complete the form below.
We require you to complete a Medical History Form.
Please click the link below to download a PDF of the form.
After you download the Medical History Form PDF, open it using Adobe Acrobat Reader. Then choose from the following options:
(Adobe Acrobat Reader is free to download here.)
We look forward to meeting you!