Dear Patient,

We welcome you to our dental practice. Please answer following questions regarding your medical and dental history so we may provide you with the best care in an appropriate and safe manner.

For your convenience, you may print, complete out and bring completed and signed copies with you for your first appointment.

Please print out, complete and bring the following forms with you to your visit:

• New Patient Appointment Info
• New Patient Medical Information
• New Patient Intake Form
• HIPAA Notice of Privacy Policies
• Request for a release of dental records and X-Ray form (New Patients)

If you wish to complete your paperwork in the office, we ask you to arrive 15 minutes prior your appointment time to allow enough time.

Thank you and we are looking forward meeting you.