Please print and complete the required forms before your appointment, and bring them with you when you arrive.

Please Read:

Privacy Practice HIPAA PDF

Office Policy on Fillings PDF

Please Fill Out:

White vs. Composite Fillings PDF

Acknowledgement of Receipt of HIPAA Notice of Privacy Practices PDF

Patient Responsibility Agreement PDF

Patient Registration PDF

Medical History PDF

HIPAA

Privacy Practice HIPAA PDF

Acknowledgement of Receipt of HIPPA Notice of Privacy Practices PDF