Forms

Simple Webforms!

Instructions:  After making your appointment, simply click each of these links, fill out the required fields, and hit submit!  When we see you at our offices, we’ll have them ready for you to approve and sign.  Thank you!

Patient Registration

Medical History Full

HIPAA

Smile Survey (Optional)

Handle Me With Care (This helps us help you!)

Financial Agreement

 

Oral Surgery Forms Only for Dr. DeLong patients:

 

Oral Surgery (Health History 1/2)

Oral Surgery (Health History 2/2)

Oral Surgery Consent (1 of 3)

Oral Surgery Consent (2 of 3)

Oral Surgery Consent (3 of 3)