On your first visit with our office we ask that you bring a few things with you to make the process of checking-in go smoothly for you.
You will need to have the forms below filled out prior to your first visit. You will also need to have your insurance card with you as well. Please bring an actual card or copy of card on paper.
If you have any questions about the forms being filled out or questions about your visit please contact our office.
Our entire team looks forward to helping you achieve your dream smile with affordable treatment tailored to your needs.
I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.
I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.