The following Patient Forms can be printed from your computer and filled out at your leisure before your first appointment. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.
Please bring in a Medical History, HIPPA (Patient Acknowledgement of Privacy Practices) Form and Financial Policy for each patient. If you have records at another dentist, please fill out and send the patient record request to them so that we will have that information at your first appointment.
If you have any questions, please do not hesitate to give us a call:
860.233.0552
Medical History.pdf
Notice of Privacy Practices HIPPA.pdf
FINANCIAL.pdf
General Consent and Statement of Responsibility.pdf
KIDS Health History.pdf
Please see our Common Questions for frequent new patient questions.
You will need Adobe Acrobat Reader to access the forms.