Patient Forms

Below are patient forms you can access as needed. Download and complete them for your convenience.

* indicates form must be completed prior to treatment

• English COVID-19 Screening Form*
• Spanish COVID-19 Screening Form*

• English New Patient Questionnaire*
• Spanish New Patient Questionnaire*

• English Returning Patients Questionnaire*
• Spanish Returning Patients Questionnaire*

• School Dental Form
• Minor Consent Form *required for any patient under 18 years with out parent/legal guardian present at time of visit
• Post Operative Instructions for Extractions

• Hospital Specialist Referral Listings
• Medical Clearance Form
• Patient Instructions for Denture Care
• Patient Instructions for Teeth Whitening
• Records Release Form