Web Registration

As part of our Patient Care System, you can enjoy the convenience of registering online with your medical information—or, if you prefer, still register in the offices of your dentists with paper forms, or even print forms at your home.

To help us give you the best service possible we have provided links on this page to Patient Registration forms for adults and children so that you can fill them out digitally prior to your first visit. We encourage you to complete the appropriate form in order for us to get a head start on the paperwork. This will help streamline your visit. If there is anything on the form that you would prefer not to fill out, please feel free to leave that particular detail blank.

The first part of each form is a basic/general information form and health history. If you have some kind of dental/medical insurance coverage, please also fill out the insurance section on the form. If you can complete this in full, it may allow you to more easily find out to what extent your dental/medical coverage may reimburse you for treatment costs (all applicable insurance/identification numbers and birthdates must be included if we are to help you with filling out insurance forms). Many oral surgical and diagnostic procedures may be covered by your medical insurance. After reviewing your information, we can usually give you an approximation of what treatment fees would apply.

The registration form is also requesting general information regarding medical and dental history, and dental insurance details. If you would like our assistance with your insurance forms, we will be happy to help.

Please fill out the online Information Forms.  You will be transferred to a HIPPA-compliant site we utilize to insure that all information provided is kept secure and confidential:

Click Links For

Adult Registration                            Child Registration