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Patient Forms

This is where you can view the various forms that are necessary in helping us to serve you with the best possible care. Please note, that clicking on a form will open it in a new window.

New Patients

New Patient - Patient Info

New Patient - Health History

New Patient - Insurance Info

New Patient - Additional Information Required

New Patient - Laser Bacterial Reduction Consent

New Patient - Sleep Apnea

New Patient - Open Chair Fee Policy

New Patient - Notice of Privacy Practices

Medical Release of Records (transferring to another office)

Front Desk - Disclosure of Health Information

Talent Release

Sleep Apnea

Sleep Apnea - Delivery Consent

Sleep Apnea - NP Consent - Financials

Sleep Apnea - NP CPAP Affidavit


Hygiene - Laser Perio Therapy Consent

Hygiene - Laser Bacterial Reduction Consent

Hygiene - Oral Cancer Screening Consent

Hygiene - Refusal - Periodontal Charting

Hygiene - Refusal - Periodontal Disease

Hygiene - Refusal - Radiograph

Hygiene - Zoom Tooth Whitening Consent


Doctor - Implant Consent

Doctor - Oral Surgery Consent

Doctor - Pre-Surgical Medical Dental History


Doctor - Implant Consent

Doctor - Oral Surgery Consent

Doctor - Partial Consent - Flexible

Doctor - Partial Consent - Metal

Doctor - Root Canal Consent

Epic Teeth Whitening

Dental Services