Download these forms and fill them out before you come in to the office to save time.
FIRST VISIT FORMS
Ensure that you don’t have to wait any longer than necessary by filling out these forms before your first visit. If you do not understand some questions, we can answer them when you come in. Please see Scheduling Your First Visit for other appointment questions, or feel free to call us at Mesa Office Phone Number 480-981-0094.
- Medical History Form, Including medication and supplement listings
- Notice of Privacy Practices (HIPPA Form)
- Financial Responsibility Form
- Consent to Release Personal Information
TREATMENT CONSENT FORMS
If you are scheduled for a tooth extraction/removal or a root canal, please download and fill out the appropriate form prior to your visit:
Please see After Treatment Home Care for post-operative instructions.