Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

  • Medical History Form PDF
  • Media Release PDF
  • Financial Agreement PDF
  • Cancellation Policy PDF
  • Patient HIPAA Consent PDF

If you're unable to open PDF files, you can get Adobe Reader® for free.

Dental Amalgam Mercury Solutions International Academy of Oral Medicine and Toxicology American Dental Association American Academy of Physiological Medicine & Dentistry International Academy of Biological Dentistry & Medicine Natural Awakenings
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