On-Line Dental Patient Forms
Please click on the links below to see downloadable Adobe PDF versions of our dental patient office forms. You must likely already have this software on your computer. If you have difficulty accessing these forms, please click here to install Acrobat Reader.
Forms for Patients
Patient Registration Form / Health Questionnaire
To expedite your initial appointment, please complete this form (along with a list of medications you are currently taking) and bring it with you to our office. It is critical that this form be completed accurately to ensure that Dr. Martinez and the dental team are aware of all medical conditions prior to treatment.
Notice of Private Policy (HIPPA)
This form presents the information that federal law requires us to give our patients regarding our privacy practices.
Informed Consent Forms
These forms explain what patients can expect during treatment as well as provide answers to the most commonly asked patient questions.
- Veneers
- Whitening
- Dental Implants
- Crowns
- Bridges
Permission to use Full Face
Dr. Martinez is involved in providing continuing education to other dentists. Dr. Martinez may request that your face in pictures be presented in these clinical presentations. You are not obligated to provide this permission.
