Patient Forms

Download Your Form

Not sure which one? If this is your first visit with us, use the Medical Health History Form. If you’re a returning patient with any change in your health, use the Health History Update Form.

What Else to Bring to Your Visit

Along with your completed form, please bring:

• Photo ID
• Dental insurance card (front and back)
• Medical insurance card (if you’re here for sleep apnea treatment)
• A current medication list — including over-the-counter drugs, vitamins, and supplements
• Any prior x-rays or records from a previous dental office
• List of allergies, especially to medications

Do You Have a Health Condition Requiring Premedication?

Some heart, joint-replacement, and immune conditions require you to take an antibiotic before any procedure that could cause bleeding — including a routine cleaning. Please let us know when you book. Read more on our Premedication page.

Privacy

Your health information is protected under HIPAA. Our full Notice of Privacy Practices is available at the front desk and by request. We never share your information without your permission except as required for treatment, payment, or by law.