Form Downloads

Your first visit to Pure Dentistry establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor. You can save some time at your first visit by printing out and completing the patient forms in advance of your appointment.

Please be prepared for your appointment by printing and completing the new patient registration forms. Your PHOTO ID, INSURANCE CARD, AND COPAY ARE REQUIRED AT THE TIME OF VISIT. If you do not have your insurance card available, all charges will be your responsibility and payable at the time of service.  Any unpaid balances and/or denied dental claims will be your responsibility.

Download, print, and fill out the forms

Pobierz, wydrukuj i wypełnij formularz