Patient Forms

PATIENT REGISTRATION

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

We value your time with us! To maximize your time during your appointment, we have put together our patient forms. Please print out the forms below and fill out to bring in to your first appointment. Thank you and we are looking forward to seeing you soon. Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

IMPORTANT: Please arrive at least 15 minutes prior to your appointment to allow sufficient time required for the registration process.  On-line registration prior to your appointment will expedite this process.

Please provide the following information at the time of your initial consultation:

  • Your surgical referral slip and any x-rays if applicable.
  • A list of medications you are presently taking.
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

A preoperative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink eight hours prior to your surgery.You will also need an adult to drive you home.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medications (i.e., heart medications, blood thinners, bisphosphonates for osteoporosis, etc.).

MINORS: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.

X-RAYS: If your dentist or physician has taken x-rays, you may request that they forward them to our office. If additional films are necessary, they can be taken at our facility.

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