Patient Forms

Call (570) 424-2445

Please download and fill all forms before coming in for your appointment . 

If you have any questions at all while completing the paperwork to call our office at (570) 424-2445.

 

 Patient Info Card

 Patient Medical Info

 Financial Responsibility Page

 Treatment Consent Form

 HIPPA

 Patient Copy of Privacy Practice Packet

 Cancellation Policy

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We combine experience with the latest in dental technology to deliver the best patient experience possible.

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