Registration Forms for New Patients

  1. Medical History (PDF)

  2. Consent to Treatment and Office Policy

  3. Financial Policy Notice

  4. Consent to Endodontic Treatment Notice

  5. Privacy Act

New Patients

New patients to our office are kindly requested to complete forms 1 through 4 and submit through fax, or bring in with you.

Patients that have been seen in our offices before

If it has been more than six months since your last visit with us or there has been major changes in your medical history, then please complete form 1 only and submit electronically, through fax, or bring in with you. You do not need to fill out any forms if you have been seen in our office in the last six months.

Post Treatment Notables

We have tried to anticipate any question that may come to the mind of our patients regarding their endodontic treatment with us. The following links are titled based on the type of treatment that you have had in our office or the stage of your treatment with us. Please feel free to use these links to review the information provided, and as always you may contact us by sending an email or calling our offices as needed.

Post Treatment Instructions

  1. Post Treatment Instructions

  2. Post Surgery Instructions

  3. Open Tooth Instructions