Patient Forms

The PATIENT FORMS link below will take you to our office portal that contains available patient forms. All patients are encouraged to click through the Patient Portal Button, available at the top of each page, to register for a personalized Patient Connect 365 Portal Account. There, you can log in to change your notification preferences, upload documents, request appointments, pay your bill online, see your appointment history and fill out patient forms. 

NEW PATIENTS: Please fill out ALL 8 (eight) forms at least 2 days prior to your appointment

  • Medical History 
  • Patient Information 
  • Dental History
  • HIPPA Consent/Authorization/Privacy Practices Forms
  • Insurance Information
  • Airway Health Screening Questionnaire

RETURNING PATIENTS: Please fill out the following forms prior to your appointments (previous information on file will autofill and you can make changes accordingly):

  • Medical History 
  • Patient Information (if changed)
  • Insurance Information (if changed)
  • 3 HIPAA Forms (yearly)

pt forms

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Hours of Operation

Our Regular Schedule

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

By Appointment Only

Saturday:

Closed

Sunday:

Closed