• Home
  • Meet Us
  • Contact
  • Connect With Us
  • Teeth FAQs
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  • Make a Payment
  • Online Forms
  • Current Patient Info
    • Post Op Instructions
    • HIPAA
  • More
    • Home
    • Meet Us
    • Contact
    • Connect With Us
    • Teeth FAQs
    • Solea Laser
    • Insurance
    • Make a Payment
    • Online Forms
    • Current Patient Info
      • Post Op Instructions
      • HIPAA
  • Home
  • Meet Us
  • Contact
  • Connect With Us
  • Teeth FAQs
  • Solea Laser
  • Insurance
  • Make a Payment
  • Online Forms
  • Current Patient Info
    • Post Op Instructions
    • HIPAA

Online Forms

New Patient Forms

If this will be the first time this patient is seen in our office, follow the link to the New Patient Forms section

New Patient Forms

Current Patient Forms

If the patient has been seen in our office, but needs to update forms, follow the link to the Current Patient Forms section

Current Patient Forms

Other Forms

Need records sent to another office? Or to give permission for your older child to come to the appointment without a parent/guardian? Follow this link to the Other Forms section.

Other Forms

Forms for New Patients

Follow this link for forms for new patients under age 18


Follow this link for forms for new patients over age 18 


The above links allow for filling out paperwork online. If you would rather print the paperwork, please choose from the following PDF files, and fill out a medical history, a registration, a HIPAA and a financial agreement for each patient

Registration for New Patient under age 18 (pdf)Download
Registration for New Patient over age 18 (pdf)Download
Medical History Kids (pdf)Download
Medical History Adult (pdf)Download
Financial Agreement (pdf)Download
HIPAA (pdf)Download

Forms for Current Patients

Follow this link for forms for current patients under age 18


Follow this link for forms for current patients over age 18


 The above links allow for filling out paperwork online. If you would rather print the paperwork, please choose from the following PDF files, and fill out a patient update and a medical history update for each patient.

Patient Update (pdf)Download
Medical History Update Child (pdf)Download
Medical History Update Adult (pdf)Download

Other Forms

The following links allow for filling out paperwork online. If you would rather print the paperwork, please choose from the following PDF files, print and bring to the appointment.


Release for Patients Over Age 18 to Allow Information to be Shared with Parents

Consent to Treat Child Under Age 18 Without Parent Being Present

Release of Records to Another Dental Office

Release for Patients Over Age 18 to Allow Information to be Shared with Parents (pdf)Download
Consent to Treat Child Under Age 18 Without Parent Being Present (pdf)Download
Release of Records to Another Dental Office (pdf)Download

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  • Home
  • Meet Us
  • Contact
  • Connect With Us
  • Teeth FAQs
  • Insurance
  • Make a Payment
  • Online Forms