PATIENT INFORMATION

• Introduction
• First Visit
• Scheduling
• Payment Options
• Insurance
• Infection Control
• Advanced Technology
• Nitrous Oxide & Relaxation Medication
• Home Instructions
• Patient Forms
• Smile Gallery

Online Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Technical Note:

Mac Users

You must open and submit the form in a Safari Browser and also have the latest Mac Operating System. It is important that you have the latest version of Adobe Reader on your computer in order to submit your form to our office correctly, please download the free plugin from Adobe's web site.

PC Users

Our online forms use the Adobe Acrobat 5 Plugin to allow patients the convenience of completing their health history and registration forms from home or work. Please download the free plugin from Adobe's web site if it is not already installed on your system. It is important that you have at least version 5 of the plugin, in order to successfully use our forms.

Patient Forms

For your convenience you may download and print the following forms:

• Click here to read the Notice of Privacy Practices This form presents the information that federal law requires us to give our patients regarding our privacy practices.
• Click here for our Dental Records Request Form
• Click here for our Patient Consent Form

This notice is a pdf document which requires the Adobe Reader software. You most likely already have this software on your computer. However, if you have difficulty reading the notice, please click here to install Acrobat Reader.