New Patient Forms Simsbury and West Hartford CT
When you call our office to schedule your initial exam, we will need to gather some basic information from you in order to send you our welcome packet. This will include our Registration, Medical History, Financial Policies, and forms related to our HIPAA practices.
If your appointment is going to be too soon for you to receive forms by mail, you have the following options:
- Download and print the New Patient forms from this page
- Request forms to be sent to you via email
- Request forms be sent to you via Fax
- Plan to arrive 15 minutes early for your appointment to allow yourself time to complete your paperwork prior to your appointment.
Please mention if you would like a Records Release form that you can forward to your previous dental home if you have any recent dental x-rays. If we do not have x-rays on file or the images we have are out of date by the time of your initial appointment, we will to take them during that time.
Downloadable Patient Forms
Please click on a title below to download and print a form. Bring your completed forms with you to your appointment. If you have any questions, please call our office: Simsbury CT Office Phone Number 860-658-1991.
- New Patient Registration Form
- Patient Medical History
- Financial Policies
- e-Communications Agreement
- Records Release to Center for Dental Excellence, LLC
- Records Release from Center for Dental Excellence, LLC
Our Privacy Practice Notification and HIPAA Policy information are available at our office.