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COVID-19 Practice Safety

Patient Forms

We take your security and privacy very seriously. All forms are encrypted and protected with 2-factor Authentication according to HIPAA guidelines.

Dental Office COVID-19 Prescreening Form

YOUR FIRST VISIT FORMS:

new patient registration Form

hipaa consent Form

ADDITIONAL FORMS:

Dental extraction consent Form

release records form

TELEDENTISTRY FORMS:

request teledentistry appointment

teledentistry consent Form


FORMULARIOS EN ESPAÑOL:

FORMULARIOS PARA PACIENTES