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  • (520) 795 1316
  • Mon–Thu 8am–5pm
    Fri 7am–12pm
  • 4015 E Paradise Falls Drive Suite 129
  • Services
  • Patient Registration
  • Payment Options
  • Our Team
  • FAQ
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Patient Registration

If you’d like to review any of our patient forms, you can find them here. You can also print them prior to your first appointment, and fill them out in advance.

  • New Patient Health History

    This is the standard patient information and medical history form we ask new patients to fill out. It includes both your dental and medical history.

    Download

  • Office Policy and General Informed Consent

    This is our standard office policy and consent we ask new patients to fill out.

    Download

  • Notice of Privacy Practices

    This is our notice of privacy practices we ask new patients to read. There is an area to sign on the next document acknowledging you have read this.

    Download

  • HIPAA Authorization and Acknowledgement of Receipt of Privacy Practices

    This form designates with whom you would like to share your private health information with, if anyone, as well as acknowledges you have read our Notice of Privacy Practices document above.

    Download

4015 E Paradise Falls Drive,
Suite 129
Tucson, Arizona 85712
(520) 795 1316
  • Services
  • Patient Registration
  • Payment Options
  • Our Team
  • FAQ
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