Patient Registration
You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Note to Patient:
- Please enter your name and birthday as you gave it to us on the phone
- Fill out both a patient registration and HIPPA form
- Please enter your medical insurance as your primary insurance
- Please enter your dental insurance as your secondary insurance