>>>>> NEW PATIENT REGISTRATION FORMS - Download
* All NEW PATIENTS, kindly fill out ALL NEW PATIENT FORMS and bring to your FIRST VISIT ~ Thank You!
* ALL CURRENT PATIENTS - NEW UPDATED HIPAA FORM, kindly fill out the New Updated Hipaa Form below and please bring with you to your next visit ~ Thank You!
>>>>> NEW UPDATED HIPAA for CURRENT PATIENTS - Download
>>>>> PATIENT ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES AND CONSENT - Download
>>>>> DENTAL HEALTH CERTIFICATE - NYS - (SCHOOL) Optional Download
The following HIPAA Form is ONLY for Referral of Health Information to be Released to another Provider or Specialist
Please Note: The complete OMNIBUS Rule HIPAA NOTICE OF PRIVACY PRACTICES is available under the OMNIBUS Rule Section under Insurance & Patient Forms Category