Patient Forms
Completing your paperwork before you arrive leaves more of your visit for your care. Here is what we need from new patients.
What Your Forms Cover
Dental paperwork usually asks for the same few things. Having them ready saves time.
Contact details
Your name, address, phone number and email, plus an emergency contact, so we can reach you about appointments and follow-up care.
Medical history
Your medications, allergies and health conditions. Some of these affect dental treatment, so please be as complete as you can.
Insurance information
Your plan name, member ID and the policyholder's details. We use these to check your benefits and file your PPO claim.
How to Get Your Paperwork Done
Gather your information
Have your insurance card, a photo ID and your medication list in front of you before you start. It makes the forms much quicker to fill out.
Complete the forms
Fill in every section that applies to you. If a question is unclear, leave it blank and our front desk team will go over it with you.
Bring them to your visit
Hand your forms to the front desk when you check in. If you could not finish them at home, come a few minutes early and complete them here.
Questions About Your Forms
Our front desk team is glad to help if you are unsure how to answer something. Call (941) 877-5262 during office hours and we can go through it together. You can also ask at the front desk when you arrive.
The health details you share are used to plan your care safely. If your medications or health change between visits, let us know at your next appointment so we can keep your record current and accurate.
