Online registration

Email us your completed forms at [email protected], or fill it out at the office.

1. Dental and medical history form: 

(PDF)

2. HIPAA authorization form: 

3. HIPAA notice of privacy practices form: 

4. Office financial policy: 

IMPORTANT: All patients under the age of 18 must be accompanied by a parent or guardian at the consultation visit. You will also need an adult to drive you home.