New Patient Forms

We have made our new patient forms available to you as Adobe Acrobat files. For your convenience, please fax the completed forms back to us at (888) 890-9412 at least one day prior to your appointment. Your privacy is ensured.

If you have any problem getting these files to download or print properly, please call our office and we will gladly send them in the mail, email, or fax them to you.

$50 Account Credit

This offer applies to new patients only. Receive a $50 account credit* after the completion of a New Patient Exam, full set of x-rays, and ultrasonic teeth cleaning.
  • $50 Account Credit
  • New Patient Exam
  • Full Set Of X-Rays
  • Full Ultrasonic Teeth Cleaning
To receive this online special, just call us and mention the keyword: "Dragonfly"
(Expires 10/31/2017)
.

*cannot be combined with any other promotion

Free Sonicare Toothbrush

This offer applies to new patients only. Receive a Free Sonicare Toothbrush* after the completion of a New Patient Exam, full set of x-rays, and ultrasonic teeth cleaning.
  • Free Sonicare Toothbrush
  • New Patient Exam
  • Full Set Of X-Rays
  • Full Ultrasonic Teeth Cleaning
To receive this online special, just call us and mention the keyword: "Ladybug" (Expires 10/31/2017).

*cannot be combined with any other promotion. Only one free Sonicare toothbrush per household.

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