New patient forms

Before your first visit

Please complete these two forms and bring them to your appointment.

• PDF
  New patient registration and medical history2 pages · your contact details, insurance and health history
  Open
• PDF
  HIPAA authorization1 page · how we protect and share your health information
  Open

You may also be asked to sign

We will review these with you at your visit. You are welcome to read them ahead of time.

• PDF
  Fee estimate and financial policy2 pages · payment options and our office financial policy
  Open
• PDF
  Treatment and sedation consent forms4 pages · root canal, microsurgery, IV sedation and oral sedation
  Open

Prefer one file? Download all forms and instructions together (13 pages).

Your privacy

The security and privacy of your personal information is one of our top concerns. Please bring paper forms to your appointment rather than emailing them, since email is not a secure way to send health information. If you have any concerns about the information you provide, please ask us. See our privacy practices.

The forms are PDF files and open in any web browser or PDF reader.