For your convenience when visiting our office, please fill out the forms in the links below completely prior to your appointment with us.
English
New Patient Form
HIPAA Form
Financial Guidelines
Maryland Healthy Smiles Appointment Policy Form
Protected Health Information – PHI Form
Spanish
New Patient Form
HIPAA
Financial Guidelines
Maryland Healthy Smiles Appointment Policy Form
Protected Health Information – PHI Form (Spanish)
A parent or guardian is required to fill out the new patient/welcome forms in their entirety prior to the first visit.
