Forms

For New Patients

Smiling patient of dentist looking at camera during oral check-up
New Patients Form

Share your your medical and dental history with us before your appointment.

a white face mask against a blue background for covid update
Covid-19 Screening

You must complete this screening form before coming to your appointment. Let’s keep everyone safe!

A 3d tooth on a yellow background next to a silver dental tool
Doctor Referral Form

Have you been referred by a doctor to see us? Please fill out this form.

Dentist working in dental clinic with patient in the chair.
Legal Referral Form

Were you in an accident that requires treatment and legal counsel? Fill out this form!

Assessments & Questionnaires

Wondering how to improve your smile or treat a painful jaw condition?

A smiling woman points at her white teeth
Cosmetic Assessment

Wishing you had a different smile? Fill out this form to see if our cosmetic dental services are right for you.

A man holds his face, indicating a toothache.
TMJ Questionnaire

Have you been dealing with headaches and pain in your neck or jaw? It could be TMJ.

A close-up of a man smiling, with dental tools held in front of his teeth.
TMJ Questionnaire (Motor Vehicle Accident Patients)

Fill out this form to see if your motor vehicle accident may have caused TMJ.

A woman sleeps, looking comfortable.
Sleep Disturbance Questionnaire

Chronically tired? Test your symptoms to find out if your fatigue could be caused by sleep apnea!