Forms

smileygirlThe following forms are available for download. Simply click on the form you need and it will be downloaded to your computer. These forms are pdf files and will open in Acrobat Reader. If you do not have Acrobat Reader click here. It’s free and will not harm your computer.  Completed forms can be emailed back to us at:  admin1@deercreekdentalclinic.com

 

 

 

Welcome Form and Medical History!    For existing patients, we also ask that a new form be completed every 3 years to be completed at office.

RECORDS RELEASE FORM   You can use this form to request records from another dental office, or for us to release your records to another dental office.

CONSENT FORM-ADULT PATIENTS   You can choose who is authorized to receive a message about your appointment and schedule your appointments-only needed for those 18 and over)

HIPAA FORM   Required for all patients.  (You can find our HIPAA Policy under “About Us”, “Our HIPAA Policy”.)