Patient Registration

Online 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. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Please assist us by providing the following information at the time of your consultation:

  • Your personal ID with photo
  • Current dental insurance card
  • Current medical insurance card
  • Your surgical referral slip and any x-rays if applicable
  • A list of medications you are presently taking