New PatientsPlease print out the Admission Form, Past Medical History Form, and Consent Form. New pediatric dental patients should also complete the dental pediatric consent form. Bring your completed forms, insurance and/or discount card, co-pay and all medications to your appointment.
Admission Form - English
Admission Form - Spanish
Medical Patient Past Medical History Form
Dental Patient Health History Form - English
Dental Patient Health History Form - Spanish
Consent Form - English
Consent Form - Spanish
Pediatric Dental Consent Form - English
Pediatric Dental Consent Form - Spanish
New Patient Handbook - English
New Patient Handbook - Spanish
Discount Program Appointment ChecklistPlease bring to your appointment all of the information that applies to your current situation to expedite your qualification process.
Discount Program Checklist
Behavioral Health Intake PaperworkPlease bring this paperwork to any intake appointment with our Behavioral Health Department.
Behavioral Health Intake Paperwork
Miscellaneous FormsRelease of Medical Records
Release of Medical Records - Spanish
Sports Physical Form
Living Will - English
Living Will - Spanish