At your first visit, you will be asked to read and fill out four new patient forms. To save time at the Office, please fill out these electronic forms online before you arrive. Clicking on the link will open new window at a secure website. When you submit your personal information at this new website, it will be sent to our Office securely using encryption just like your banking website.

New Patient Forms

Established Patient Login

The first form is a consent for internet communications. The second form is a consent to do dental work. The third form is our financial policies. The fourth form is the personal, insurance, and medical/dental history information.

We will have you sign these forms electronically at the Office. Please read them so you know what you will be signing. If you have any questions, please feel free to ask.

For your convenience, the first three consent forms are referenced below. To view a document, click on the name of the document. To save a document, right click on the name of the document and select “Save Target As…”. You will need Adobe Reader to view the documents.

Consent for Internet Communications, Consent to Proceed, and Financial Policies

The following form is our Health Insurance Portablity and Accountability Act (HIPAA) Privacy Policy.

HIPAA Notice of Privacy Practices

You do not need to download the next form. It is placed here for informational purposes only. It is a longer version of your privacy rights according to the Health Insurance Portablity and Accountability Act of 1996 from the U.S Department of Heath and Human Services website.

HIPAA Notice of Privacy Practices In Depth Summary