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Patient Forms

Printable Forms

If you prefer, you may download and print our forms to complete at home and then bring them with you to your appointment. 

1. Parent/Guardian Registration Form 

2. Patient Registration Form

Notice of Privacy Policy

The Health Insurance Portability and Accountability Act (HIPAA) requires that health providers keep your medical and dental information private. You may access our full Notice of Privacy Policy here

If you’re unable to read PDF files, you can download Acrobat Reader free from Adobe.

usdiAmerican Dental AssociationAmerican Academy Of Pediatric Dentistry