Patient Registration
Upon requesting a consultation or appointment in our office you will be asked to complete our New Patient Registration Form prior to coming in. Our office, in an effort to be as paperless we can be, has created this form electronically. One of our staff members will send you an email with a link to complete this form shortly after your call. Please note that this is a one time use link and must be completed during one sitting (this usually takes 15-20 minutes to complete). If for some reason you are having trouble accessing the link please try clicking the blue button below or call our office for assistance.
Make sure you enter valid information such as Name, Date of Birth, Phone Number, Email, and Home Address. If you are not the subscriber to the dental insurance, please make sure to fill out the questions regarding the insurance subscriber. When you get to the health questions please answer truthfully, marking either yes or no for every single question. If there is no question on a certain health alert or medical condition that applies to you, please make sure to inform our office. There should already be a spot for you to directly type it into the form after the yes or no questions.
After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. Once your form has been completed and sent, our office will get an email notification and one of our staff members will review it. After reviewing your forms, there might be a need to obtain medical records from your Medical Doctor. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.