Forms

We have elected to place these pages on our web site to make your first visit to our office quick and easy.  They are provided in Adobe format so you can fill them out directly on your computer screen and then print them out.  Then simply sign the areas indicated and bring them with you to your appointment.  For those areas that require a yes or no answer please take a moment to place and “X” in the correct box for each of your answers. 

If you don’t have a printer or would simply like our office to provide these pages to you please feel free to call and we’ll mail them out to you right away.  Please realize these will arrive via snail mail and may take a few days. 
 

Patient Forms

Welcome Letter
Notice of Privacy Practices
Receipt of Notice of Privacy Practices
Health History
Financial Policy

Doctor Forms

CEREC in Your Own Backyard Registration Form
Exotics in CEREC Cruise Booking Form
Exotics in CEREC Cruise Flyer
Exotics in CEREC Group Pricing
Exotics in CEREC Introduction