Patient Forms

For your convenience, you can now fill out all forms online before your appointment. All you have to do is click on the clip board next to the form you want to fill out. Be sure to hit "submit" at the end of each form.
(Please review the first three forms before first appointment)

 

  • *Patient Registration Form
  • *HIPPA Consent Form
  • *Photo Release Form

 

 

Miscellaneous Forms:

 

 

  • Retention Contract
  • Patient Auto-Payment Form
  • Notice of Privacy Policy
  • TMJ Form
  • If you're unable to open PDF files, you can get Adobe Reader® for free.
paint your smile
our rewards card
refer-a-friend contests and info contests and info