Patient Forms

Improve your smile Today!

Improve Your Smile Today!

Overview

Save time at your first appointment by filling out our patient forms ahead of time!

Please take a minute to print and fill out the patient information form before your first appointment:

  • Patient Form (Adult) PDF
  • HIPAA Form PDF
  • Use and Disclosure of Protected Health Information PDF
  • Financial Policy PDF

If you are in need of a Pediatric Dentist, we recommend our neighboring office, Dr. Shelly K. Clark Dentistry for Children.

  • Patient Form (Child) PDF

If you’re unable to open PDF files, you can get Adobe Reader® for free.

Testimonials

See Why Our Patients Love us!

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