We are currently experiencing phone issues due to an outage in our area. If you have an after hour emergency, please contact Jessica Goodman at 631-275-0768. If you have a question during office hours, please email [email protected].
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New Patient Forms

For your convenience when visiting our office, please fill out the forms in the links below completely prior to your appointment with us.

Spanish

New Patient Form
HIPAA
Financial Guidelines
Maryland Healthy Smiles Appointment Policy Form
COVID-19 Consent Form

English

New Patient Form
HIPAA Form
Financial Guidelines
Maryland Healthy Smiles Appointment Policy Form
COVID-19: Treatment Consent Form

A parent or guardian is required to fill out the new patient/welcome forms in their entirety prior to the first visit.

 

Patient Rewards

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Meet Our Doctors

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Buddies Not Bullies

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Click here to read about our COVID-19
updated office procedures.

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