Waters Family Dentistry

New Patient Forms

Prior to your first patient visit, we ask you complete several new patient forms. These are available in both English and Spanish. The first form consists of basic contact information, any dental insurance, your dental and medical history. You will also be asked to review and complete a HIPPA (Health Insurance Portability and Accountability Act) document. In this document, you will be asked to identify any individuals to whom you authorize a release your records. This form is reviewed and updated every five years.

There are several ways to access new patient forms. The new patient form is available to download and print below. We are also happy to mail these forms to your home prior to your first appointment. If time does not permit completing the forms in advance, we ask you to arrive 10 minutes prior to your appointment to allow time to complete the forms.

New Patient Form

New Patient Form (Spanish)

Have Questions? Get in Touch