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Patient Forms

Help us get to know you!

Feel free to print and fill out your new patient forms prior to your appointment or arrive 20 minutes early to fill out the forms in our office. Be sure to read the radiograph policy prior to your appointment day.

For your convenience, we have provided a release you can send to your previous dentist should you wish to have them forward your records to our office prior to your visit.

If you have any questions along the way, feel free to contact us at (731) 424-2651.

Moving out of town and need us to send your xrays or records for you?  Simply click on the form below and we will be sure to expedite your request.

Click here for our current Notice of Privacy Practices.

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

We look forward to seeing you soon!