Patient Forms

If you are a new patient to our office, the forms below will need to filled out when you arrive for your first appointment in our Pompton Lakes dental office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  Thank you and please contact our family & cosmetic dental office if you have any questions or need any assistance.

Patient Welcome Form

New Patient Registration Form

HIPAA Privacy Act

ADA Patient Screening Form

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.