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Creating smiles in the Silver Lake area for over 25 years

NEW PATIENT FORMS

New Patient Registration

Expedite your new patient visit by filling out the information below!

Below you will find our new patient registration forms, please fill them out and click SUBMIT for each one. Clicking SUBMIT is very important for these forms to reach our office. If you would prefer to download the forms and fill them out at home, please click on the links below.

Patient Information


Insurance Information


Medical History


Dental History


Communications Release


Acknowledgement