We value new patients and welcome you to our practice. To become established as a patient, there are several forms that you must complete. These forms are designed to accomplish a number of necessary functions.
- General Information form allow us to know how to contact you.
- Insurance Information form helps us to file your insurance for you.
- Medical Information and Medical History forms are necessary to help us provide the best quality care without unnecessary compromises to your health.
- HIPAA form is required by law and is designed to help protect your privacy.
- Financial Policy form provides information about our payment and insurance policies.
- Authorization to Release Dental Records form allows us to obtain your dental records from your previous or current dentist.
After you download and print the forms, please fill them out completely. Bring them with you to your appointment.
- Complete New Patient Forms
- General Information
- Medical Information
- Medical History
- Medication Update
- Dental History
- Insurance Information
- Financial Agreement
- HIPAA Statement
- Release of Dental Records to Dr. Brown
- Release Dental Records to another provider