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.
NEW PATIENT FORMS
New Patient Form – 14 and UpNew Patient Form – 13 and UnderOffice Policy - All PatientsConsent to Release InformationHIPAA Notice of Practice - TO READHIPAA Notice of Practice Policy- TO SIGN- All PatientsDental Records Release Form - Please use this if you would like records from your previous dentist released to our office. DO NOT SEND TO US
It is our office policy to have updated medical history forms once a year. If you are a current patient please use one of the links below to download the proper forms and bring them with you to your appointment. Thank you and please call with any questions.
EXISTING PATIENT FORMS
Medical History Update Form - 14 and upMedical History Update Form - 13 and under
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.
Again I had a great visit with Mary Joy & Dr Phillippi. They continue to watch out for my dental health. This visit we discovered I'm grinding my teeth, so I will have a mouth guard made by Dr Phillippi. The mouth guard will prevent future very expensive repairs. In over 20 years I have never been disapointed in service, or quality of the work they do. I look forward to my visits they are just the best
Dr. Phillippi and Dr. Kwon as well as the entire staff are fantastic. Thanks for making going to the dentist and enjoyable experience!
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