New Patient Health History

It is important that we know about your medical and dental history. These facts have a direct bearing on your dental health and any potential dental treatment. 

Please download and print this health questionnaire.  Then simply fill out and complete and sign this health questionnaire. This allows you to complete the paperwork in the privacy and comfort of your own home and avoids waiting time in the dental office.  This information is strictly confidential and will not be released to anyone. Bring the completed form with you to your first appointment.

New Patient Health Questionnaire

Thank you for taking the time to fill out this questionnaire.

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