Streamlined Registration Process
We’ve made your dental visit more convenient by offering secure online forms that you can complete from the comfort of your home or office. Completing your paperwork in advance saves valuable time during your appointment and allows us to focus on your dental care rather than administrative tasks. Our digital forms are secure, HIPAA-compliant, and designed to gather all the essential information we need to provide you with safe, personalized dental care.
Please plan to arrive 15 minutes early for your first appointment, even if you’ve completed forms online, as we may need to verify information, collect insurance cards, and ensure all documentation is complete. If you prefer to complete forms at our office or have questions about any sections, our friendly staff is always available to assist you. We appreciate your cooperation in helping us make your dental experience as smooth and efficient as possible.
Required Forms for New Patients
Patient Registration Form
Description: Basic demographic and contact information, including name, address, phone numbers, email, emergency contact, and insurance details.
Estimated Time: 5-7 minutes
Download: [PDF Link] | Complete Online: [Online Form Link]
Medical History Questionnaire
Description: Comprehensive health history including current medications, allergies, previous surgeries, and medical conditions that may affect dental treatment.
Estimated Time: 8-10 minutes
Download: [PDF Link] | Complete Online: [Online Form Link]
Dental History Form
Description: Information about your previous dental experiences, current concerns, treatment preferences, and oral health goals.
Estimated Time: 3-5 minutes
Download: [PDF Link] | Complete Online: [Online Form Link]
Insurance Information Form
Description: Detailed insurance coverage information, including primary and secondary insurance, policy numbers, and subscriber details.
Estimated Time: 3-4 minutes
Download: [PDF Link] | Complete Online: [Online Form Link]
HIPAA Privacy Notice and Consent
Description: Important information about our privacy practices and your rights regarding protected health information.
Estimated Time: 2-3 minutes to review and sign
Download: [PDF Link] | Complete Online: [Online Form Link]
Forms for Current Patients
Medical History Update
Description: Annual update of medical information, medications, and health changes since your last visit.
When Needed: Annually or when health status changes
Download: [PDF Link] | Complete Online: [Online Form Link]
Insurance Change Form
Description: Update form for changes in dental insurance coverage or benefits.
When Needed: When insurance changes
Download: [PDF Link] | Complete Online: [Online Form Link]
Pre-Treatment Consultation Form
Description: Specific information gathering for planned treatments, including questions about preferences and concerns.
When Needed: Before major treatments
Download: [PDF Link] | Complete Online: [Online Form Link]
Treatment-Specific Documentation
Informed Consent Forms
Description: Treatment-specific consent forms explaining procedures, risks, benefits, and alternatives for various dental treatments.
When Needed: Before specific treatments
Available For: Root canals, extractions, cosmetic procedures, surgical treatments
Post-Operative Instructions
Description: Detailed care instructions for optimal healing after dental procedures.
When Needed: After surgical or extensive treatments
Available For: Extractions, root canals, periodontal treatment, oral surgery
Financial Agreement Form
Description: Payment arrangements, financing options, and financial responsibility acknowledgment.
When Needed: For treatment plans exceeding insurance coverage
Download: [PDF Link] | Complete Online: [Online Form Link]
Important Instructions
Before Completing Forms
- Set aside 15-20 minutes to complete all new patient forms thoroughly
- Have your insurance cards, medication list, and previous dentist information readily available
- Ensure you have a stable internet connection if completing forms online
- Contact our office if you have questions about any form sections
Required Information
- Personal Information: Complete legal name, current address, phone numbers, and email
- Insurance Details: Primary and secondary insurance information, including policy and group numbers
- Medical History: All current medications, dosages, allergies, and medical conditions
- Emergency Contact: Name and phone number of someone to contact if needed
Form Submission
- Online forms are submitted automatically upon completion
- PDF forms can be emailed to [email address] or brought to your appointment
- All information is kept strictly confidential and HIPAA-compliant
- Forms should be completed at least 24 hours before your appointment, when possible
Need Help with Forms?
Online Form Assistance
If you experience technical difficulties with our online forms, please call our office during business hours. Our staff can assist you with form completion or provide alternative submission methods.
Alternative Options
- Phone Assistance: Complete forms over the phone with our staff
- In-Office Completion: Arrive 30 minutes early to complete forms at our office
- Email Submission: Download PDF forms and email completed versions
- Print and Bring: Print forms at home and bring completed forms to your appointment
Accessibility Options
We accommodate patients with special needs or accessibility requirements. Please contact our office to discuss alternative form completion methods or assistance options.
Your Information is Protected
HIPAA Compliance
All patient forms and information are handled in strict compliance with HIPAA privacy regulations. Your personal health information is protected and will only be used for treatment, payment, and healthcare operations as outlined in our Privacy Notice.
Secure Technology
Our online forms utilize secure, encrypted technology to protect your personal information during transmission. All data is stored on secure servers with multiple layers of protection to ensure confidentiality.
Information Usage
Your form information is used exclusively for providing dental care, processing insurance claims, and communicating about your treatment. We never share patient information with unauthorized parties or use it for marketing purposes without explicit consent.
Questions About Forms?
Form-Related Inquiries
- Technical assistance with online forms
- Questions about specific form sections
- Alternative completion methods
- Privacy and security concerns
- Missing or incomplete form notifications
FAQS
How long before my appointment should I complete forms?
We recommend completing forms at least 24 hours before your appointment when possible. This allows our team to review your information in advance and prepare for your visit. However, forms can be completed up until your appointment time if necessary.
What if I don't have all the required information?
Complete as much as you can and bring any missing information to your appointment. Common items patients forget include insurance group numbers, previous dentist contact information, or specific medication dosages. Our staff can help gather missing information.
Are the online forms secure?
Yes, our online forms use secure, encrypted technology and are fully HIPAA-compliant. Your personal information is protected during transmission and storage. We use the same security standards as online banking and healthcare systems.
Can someone else complete forms for me?
Adults must complete their own forms or provide written authorization for someone else to complete them. Parents or guardians can complete forms for minor children. Spouses can complete forms with verbal consent from the patient.
What if I need to update my information after submitting forms?
You can update information by calling our office, submitting a new form, or providing updates during your appointment. We encourage patients to keep their information current, especially medical history and insurance details.
Do I need to complete forms for every visit?
New patients complete comprehensive forms once. Existing patients only need to update information when changes occur or annually during routine visits. We’ll notify you when updates are needed and provide appropriate forms.
