Patient Forms

There are two sets of forms provided below: one set that pertains to existing patients and one set that pertains to new patients.  If you are an existing patient, please see the .pdf files provided below.  If you are a new patient, skip to the section provided below entitled "NEW-PATIENT FORMS".

• Medical History
• COVID-19 Screening Questionnaire and Informed Consent.

NEW-PATIENT FORMS

Welcome Aboard!  It is important that we have detailed information about you to allow for us to provide dental care for you in a safe and efficient manner.  For these reasons, it is necessary that paperwork be completed prior to treating you as a patient.

There's an option of completing the required paperwork once you've arrived at our office for your intial visit.  If so, please allow for an additional 15 to 20 minutes in order to carefully complete the paperwork that's needed.  However, for your convenience, there are two options provided here that will allow you to save time at our office:

1) Complete the "New Patient Online Questionnaire" provided below online then submit this electronically using secure HIPAA-compliant encryption; or

2) Print the appropriate pdf. files provided below, fill these out prior to your first appointment, then hand these in upon your arrival.

We look forward to welcoming you aboard at Venetian Pointe Dentistry soon!

• New Patient Online Questionnaire
• New Patient Questionnaire - Adult (PDF)
• New Patient Questionnaire - Child (PDF)
• Notice of Privacy Practices (PDF)
• New Patient Billing Information(PDF)
• New Patient Acknowledgment of Receipt of Notice (PDF)
• New Patient COVID-19 Screening Questionnaire and Informed Consent.

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