New Patient Forms

When you visit us for your first appointment we will need some information on your dental and medical history. To help speed things along when you arrive, our New Patient Forms are available below.

Please print the first 3 forms, complete the information, and bring the completed forms to your appointment:

New Patient Form
New Patient Medical History
HIPAA Notice of Privacy
Sharing Info Form

These forms are available as PDF files to view and print. If you are unable to view or print, please call us at 888-Smile-10 and we will mail you the forms. You can also plan to arrive a little early to your first appointment to fill them out.

We look forward to welcoming you to our practice and serving the needs of you and your family for years to come.

Schedule your appointment

Call us now or use the appointment request on this page to schedule your visit.

Request an Appointment

Our Patient Promise

  • 5 minute or less wait-time
  • Same-day new and emergency appointments
  • Insurance benefit analysis
Learn More
TO SCHEDULE AN APPOINTMENT CALL US TODAY AT 1-888-Smile-10 (1-888-764-5310)