Forms

The following patient forms are now available. Each one can be downloaded, filled out directly on your device, and printed.

Registration Form

Notice of Privacy Practices

Dental Child Health History

Dental Adult Health History

Sliding Fee Discount Application

Patient and Center Rights and Responsibilities

Annual Authorizations

Medical Records Release Form

Consent to Treat Minor Child

*The files above are in PDF format and can be opened by most web browsers. Acrobat Reader is also supported.

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