Forms

For New Patients

New Patients Form

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

Covid-19 Screening

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

Doctor Referral Form

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

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?

Cosmetic Assessment

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

TMJ Questionnaire

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

TMJ Questionnaire (Motor Vehicle Accident Patients)

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

Sleep Disturbance Questionnaire

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