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Patient Forms

Welcome new patients! Please print and fill out the 3 forms below. Remember to bring them with you to your appointment. Otherwise, please plan to arrive 20 minutes early for your appointment so you will have time to fill them out in the office.

 Patient Information

 

 Health Questionnaire

 

 HIPAA Information (read only - no need to print)

 

 HIPAA Form

 

 

Other Forms:

 Request for Records Transfer

 

 Records Release from Family Dentistry