Patient forms are not available yet. The practice is under construction and is not registering patients, so there is nothing to complete. This page explains what will be required and how, so there are no surprises later.

What the forms will cover

  • Patient details and contact information
  • Medical history, including conditions that affect dental treatment and healing
  • Current medications and supplements
  • Allergies, including any reaction to local anesthetic or latex
  • Dental history, including previous treatment and any difficulties you have had
  • Insurance details, if you have coverage
  • Consent for examination and treatment
  • Acknowledgement of the Notice of Privacy Practices

How you will complete them

Forms will be sent ahead of your appointment so you can complete them at home. Filling in a medical history while sitting in a waiting room is how important details get missed, and it eats into time that should be spent with your provider.

Paper copies will be available for anyone who prefers them, and the front desk will help if you would rather work through it together.

A note on privacy and security

Health information belongs in a system designed to hold it. When intake is live, forms will be completed through a system selected for that purpose, and the practice will provide its Notice of Privacy Practices describing how your information is used and protected.

In the meantime, please do not send medical, dental, insurance, or financial details by email or through the contact form on this website. Email is not a secure channel, and the forms here are for general questions only.

We are not going to describe this website or its forms as HIPAA compliant. That claim requires the entire technology stack and workflow to have been verified, and that verification has not been completed. When patient intake goes live it will run on a system evaluated for the purpose, and we will say plainly what that system is.

What you can do now

Nothing is required. If you would like to be ready, the useful preparation is simply knowing your medications, your physician’s details, and the name of your previous dental practice so records can be requested when the time comes.