Patient Forms

 
If you are new to the practice, please click on the documents provided below and have the appropriate forms filled out prior to your appointment. We ask that you arrive 10 minutes prior to your appointed time so that we can enter all of your information into our computers.

If you have dental insurance, please bring your ID card or a claim form that has the insurance company name, claims address and phone number as well as a group number.

If you would like us to request records from your former dentist please click on the document for Records Release and fill out the appropriate information and bring that as well.

If you are interested in Zoom! a copy of information and consent are available by clicking on the Informed consent for Zoom! document.

If you are interested in our take home system, please click on the document Take Home Bleaching.

   
   
4250 Hempstead Tpke. Suite 7, Bethpage, NY 11714
Phone: 516-735-3550 • Fax: 516-735-8067