If you are new to our clinic, please print off the PDF form below and bring completed to your appointment.
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Finishing the forms prior to your appointment will allow us to attend to your dental treatment in a more timely manner. Please feel free call our office if you have any questions.
I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act. I understand that by hitting "Submit" I am opting into receiving text, emails, and phone calls relating to booking a dental implant consultation.
