Patient Forms to Complete

If you are able, you may now complete your new patient paperwork on the computer. Click here to open the PDF document, save to your computer, fill it out, save, and email it back to us at positivelypda@gmail.com.

If you do not have access to a printer, you may call our office and we will be happy to mail the forms to you, or arrive to your appointment at least 15 minutes early so you can complete them in our waiting area. Please review our Notice of Privacy Practices here.

 

Medical History Form

Dental History Form

Patient Registration Form

Financial Agreement and HIPPA Acknowledgement

Photographic Release Form