Patient Registration forms

• Medical History/Patient Registration (PDF)
• Consent for Treatment (PDF)
• HIPPA Notice of Privacy Practices (PDF)
  • No Need to print HIPPA notice, just read and sign acknowledgement
• HIPPA Acknowledgement (PDF)
• COVID ADA Patient Screening Form (PDF)
• GentleWave Procedure Info (PDF)

Please complete these forms and bring to your appointment. You can also email your completed forms ahead of time to [email protected]