New Patient Forms
The first two links listed below are the necessary forms required the day of your initial visit to our office. Thank you for downloading, printing, and completing the questionnaires and bringing them with you to our office. Please read the Notice of Privacy Practices, but printing it is optional. If you have any questions, please feel free to call our office and a staff member will be happy to help.
- Patient Information Registration & Acknowledgement (pdf format , will print 2 pages)
- Patient Medical Questionnaire (pdf format, will print 2 pages)
- Notice of Privacy Practices (pdf format, will print 5 pages)
Caring For Your Mouth After Treatment
Congratulations! You have completed your procedure well. Should you have any questions regarding how to take care of your mouth after your procedure, please refer to the links below. If you have any questions, please call our office and a staff member or Dr. Samuel will be happy to assist you.