New Patient Registration
Complete this form before your first visit to save time at check-in. Takes about 8 minutes.
Forms & Resources
Patient & Staff Forms
Every patient form can be filled out online or printed as a blank PDF. Submissions are saved to your chart automatically.
Patient Forms
Choose to fill out online (recommended — auto-saves as you go, signed electronically) or print a blank PDF to fill out by hand.
Medical History Update
For returning patients — quick update on changes to your medical history, medications, or allergies since your last visit.
Informed Consent for Dental Treatment
Informed consent for dental procedures. Adapts based on your treatment (extraction, root canal, crown, implant, sedation, etc.).
HIPAA Notice of Privacy Practices Acknowledgement
Acknowledge our Notice of Privacy Practices and set how we may contact you about your care.
Financial Agreement & Treatment Plan Acceptance
Treatment plan acceptance + financial responsibility. Signed when treatment is planned.
Authorization to Release Patient Records
Authorize the release of your dental records to or from another provider, attorney, or insurance company.
Photo & Marketing Release
Optional. Authorizes use of your photos or testimonial for practice marketing. Granular per-channel opt-in.
Consent for Treatment of a Minor
For patients under 18. Parent or legal guardian authorizes dental care and sets parental-presence preferences.
Other Requests
Appointment requests, insurance checks, and provider referrals.
Request an Appointment
Tell us your preferred date and time and our team will call you to confirm within 1 business day.
Open form →Free Consultation Request
Request a free phone consultation with one of our doctors to discuss your dental needs.
Open form →Insurance Verification
Check if we accept your dental insurance plan. Our team will verify your coverage and follow up within 1-2 business days.
Open form →Provider Referral
For referring dentists and healthcare providers. Submit a patient referral to our practice.
Open form →Post-Op Instructions
Care instructions after your dental procedure. View online or download as PDF.
After Tooth Extraction
Follow these instructions carefully to promote healing and prevent complications.
View & Download PDFAfter a Dental Filling
What to expect after your filling and how to care for it.
View & Download PDFAfter Root Canal Treatment
Important care instructions following your root canal procedure.
View & Download PDFAfter Crown or Bridge Placement
Caring for your new crown or bridge.
View & Download PDFAfter Deep Cleaning (Scaling & Root Planing)
Instructions for recovery after your deep cleaning procedure.
View & Download PDFAfter Teeth Whitening
Maximize your results and manage sensitivity.
View & Download PDFPatient Resources
Helpful guides for before and after your visit.
Pre-Appointment Checklist
Everything you need to prepare for your dental visit.
View & Download PDFOral Hygiene Home Care Guide
Daily habits for a healthy smile between dental visits.
View & Download PDFDental Emergency Guide
What to do in a dental emergency before you reach our office.
View & Download PDFNeed help with a form?
Call us at (619) 265-2262 or reach out through our contact page.