Forms
Find many of our office forms below to download. If you have any questions about any of our forms feel free to call us to discuss.
Forms to complete and bring to the 1st visit
Please download and sign the following 5 documents and bring them to the 1st visit:
- new patient information
- general consent form
- acknowledgement of privacy practices
- release of information authorization
- scheduling policy
Also read the notice of privacy practices. You do not need to sign anything with the notice of privacy practices.
Hosptial Treatment (OR) Post Operative Froms
Our OR post operative forms can be downloaded in spanish or english.
| Form | Description | Download |
|---|---|---|
| New Patient Information | Please fill out both pages. Fill out the medical history section as thorougly as you can. |  |
| General Consent form | This form is our general consent form for visits to our office. | |
| Notice of Privacy Practices | Read this document. There is nothing to sign. HIPPA requires that this document is offered to all patients. | |
| Acknowledgement of Privacy Practices | Sign this after you understand our notice of privacy practices. | |
| Release of Information Authorization | This form allows you to authorize us to discuss you child's dental information with anyone that may bring your child to an appointment other than the guardians. Note: this allows discussion only, not consent. | |
| Scheduling Policy | Please sign our form that explains our scheduling policy | |
| OR Post Op Instructions | Post operative instructions for treatment in the OR (hospital) | |
| INSTRUCCIONES DESPUÉS DE LA CIRUGÍA | En Espanol | |
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