Patient Forms

COVID Pre-Screen

Your Health And Safety Always Rank #1 With Us.

You’ll notice a few differences when you visit, but the care you receive won’t be one of them. Here are a few things you’ll see:

  • We will use no-touch mobile communications such as text, email and phone.
  • We will ask you to wait in your car and text us upon arrival.
  • Hand sanitizer is readily available.
  • Temperature checks help us screen everyone.
  • We’re using some new protective gear.
  • If you’re not feeling well, we can help you reschedule.

There are also a few things behind the scenes that might not stand out. Just a few include:

  • Added cleaning and disinfection of public spaces.
  • Continued strict sterilization monitoring.
  • More training than required on protective measures

Did we mention that we’re excited to see you? But before we do, please take a minute to fill out the new patient forms by clicking below! Thank you.

New Patient Paperwork

ADA Health History Form

HIPPA Acknowledgement

Financial Policy

Dental Treatment Consent Form

ADDC Financial Agreement

Consent For Services and Financial Policy

Contact Us

  • * All indicated fields must be completed.
    Please include non-medical questions and correspondence only.
  • This field is for validation purposes and should be left unchanged.

Office Information

Office Hours

Mon - Thurs: 8:00am - 5:00pm
Friday: 8:00am - 1:00pm
Weekends: Closed 

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