If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.
Patient Forms ( Print & Complete All Forms Prior To First Office Visit)
HiPAA - Notice of Privacy Practices
New Patient Registration - Adult
New Patient Registration - Child
MEDICAID - Visit Documentation
MEDICAID - Carries Risk Assessment Tool
MEDICAID -Dental Risk Assessment Questionnaire - Spanish
MEDICAID - Dental Risk Assessment Questionnaire - English
MEDICAID - Oral Health History Questionnaire - Spanish
MEDICAID - Oral Health History Questionnaire - English
MEDICAID - Visit Policy
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
Dr. Justin and his staff are wonderful!! Very friendly and professional. I am super cowardly when it comes to seeing the dentist and they made all my fears go away. It feels nice to look forward to going to the dentist. Thank you Family Dentist!!
Crystal
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