


In order to make the new patient registration process as quick and easy as possible, we have posted all of the forms we require you to fill out upon arriving. Please click on the various links below and print the forms. Fill in all requested information and bring the forms with you on the day of your appointment. If you have any difficulties with completing the forms, please call (305) 538-8835.
These forms are in .pdf format. If you are unable to view you will need to download the necessary plug-in.
Form 1: Agreement to Treatment
Form 2: Agreement to Treatment (en español)
Form 3: Patient Payment Policy
Form 4: Patient Policy Acknowledgement
Form 5: Patient Policy Acknowledgement (en español)
Form 6: Patient Verification on Income
Form 7: Privacy Notice
Form 8: Registration Financials
Genetic Screening Questionaire - Español
Genetic Screening Questionaire - English
DENTAL PATIENTS FORMS
Dental Medical History Form - Español
Dental Medical History Form - English
Dental Notice of Privacy Practices
Patient Confidentiality - Español