Patient Information

Adult Patient Forms

• Medical History Form
• Dental History Form

Child Patient Forms

• Child Health History Form

New Patient Specials

• With a new patient exam and cleaning, we will give you a free take-home teeth whitening treatment. This includes custom whitening trays.
• If you prefer the faster in-office whitening, we will discount a one-hour Zoom! whitening treatment to $395 from our regular price of $750.

Request an Appointment