To save time at your first dental visit, we provide you with the Patient Information and Health History Form to fill out at home and bring with you to your visit.
This is a PDF form. When you click the link, the form will open if you have Adobe Acrobat Reader (if not, click on the Adobe Acrobat Reader link, where you can download Adobe Acrobat Reader).
You can fill in much of the information on your computer before you print the document, or you can simply print the form and fill it all in by hand. Some areas require you to circle an item, check a box, or write in information.
When you have finished on the computer, print the form and fill in those areas by hand (as required). Don’t forget to sign the Dental Insurance section at the very bottom of the page.
Bring this form with you to your dental visit: