Your Initial Visit – Patient Forms

Your first visit will be a consultation appointment. During this visit, Dr. Clark, Dr. Cole, or Dr. Patel will review your medical history, medications, allergies and your treatment options.

Please bring the following to your consultation appointment:

• Completed Patient Referral Form from your dentist

• All of your insurance information

• A list of your current medications

• A list of your physicians

Unmarried patients under the age of eighteen are considered minors.  They must be accompanied by a parent or legal guardian.


Please download and fill out the appropriate information form.
Please bring this form with you for your initial appointment.

Adult patient information record

Minor patient information record

Additional Downloadable Forms-

Patient Referral Form

Surgical Instruction Sheet

Postoperative Instruction Sheet

Privacy Practices and Patients Rights

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