Patient Forms

Prepare for Your Visit

To streamline your visit, we have made our patient forms available online. Please take a moment to fill out the necessary forms before your appointment to help us provide you with the best possible care. If you have any questions, feel free to contact us.

• Patient Registration Form – Provide us with your personal information, insurance details, and emergency contact information.
• Medical History Form – Share important information about your health, medications, and previous medical conditions to ensure safe and effective treatment.
• Privacy Policy – Acknowledge that you’ve received our Notice of Privacy Practices outlining how your personal health information will be used and protected.
• Office Financial Policy – Understand our payment policies, including insurance, co-pays, and payment options for services.
• Broken Appointment Policy – Familiarize yourself with our policy for missed or late appointments to help us serve all patients effectively.
• TMJ Questionnaire – Help us assess your symptoms and determine the best treatment options for your TMJ issues.
• X-Ray Consent Form – Consent to have x-rays taken as part of your diagnostic evaluation and treatment planning.

Please download and complete the forms before your visit. If you’re unable to fill them out in advance, please arrive 15-20 minutes early to complete them in the office.

We look forward to seeing you at your appointment!