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Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

Foothills Dental Account Holder Form

Dental/Medical History Form

Receipt of Notice of Privacy Practices Form

Consent for use and disclosure of Health Information

Foothills Dental Associates Notice of Privacy Practices

If you have any questions regarding which forms you might need before coming in for your appointment, please call us at
(770) 893-2340 for more information!


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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