Patient Forms



  • Patient Screening Form
    • First column marked "Self-Assessment" to be completed be each patient ~2 weeks prior to each appointment
    • If you are a minor: This form will also need to be completed for (1) parent or guardian if he/she will be accompanying you to your appointment

For New Patients:

Please complete all of the following forms. Please click the "Submit" button at the upper left corner upon completion:

Please review the following documents:

  • HIPAA Notice | PDF
  • Dental Materials Fact Sheet | PDF

For Existing Patients:

Treatment Consent Forms:

Oral Surgery Consent Forms:

Orthodontic Treatment Consent Forms:




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Business Hours

Monday9:00 AM - 6:00 PM
Tuesday9:00 AM - 6:00 PM
Wednesday8:30 AM - 5:30 PM
Thursday8:30 AM - 5:30 PM
Friday8:00 AM - 5:00 PM

Contact Us

Request An Appointment