Print the Forms You Need

For your convenience we have made available the following patient forms in PDF format.

• Patient History
• Patient Information
• Financial Policy
• HIPAA Form
• HIPAA Acknowledgement
  
• Mid-Valley Dental Authorization to Release Dental Records

 

For Current Patients

• Patient History Update

You can print these forms, fill them our at your leisure and bring them with you on your first visit.

Additional Documents

• Pre-Op Sedation Instructions
• Post-Op Insructions

Spanish Forms

• Patient History - Spanish
• Patient Information - Spanish