dental patient filling out forms

Patient Forms - Danbury, CT

Patient Forms

Forms

In this section, you can choose which intake form to fill out. It is a TWO page form, in either English or Spanish so please remember to print both pages. First, click on the links of your choice. When the form(s) appear, RIGHT-CLICK on each of the pages and select “PRINT”.

Of course, you also have the option to fill out the form(s) during your initial visit!

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I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.