Patient Screening Form

We’re passionate about building strong relationships with our patients and focus on your immediate and long-term goals. The first step in achieving those goals is to schedule an appointment. Contact us today and a representative from our team will work with you to confirm an appointment.

Due to recent changes involving COVID-19 and recommendations from the ADA, we would like to gather more information before your next visit. Please answer the easy questions below, completing the form should take about one minute. Positive answers to any of these questions will likely necessitate further discussion and inquiry from one of our doctors before proceeding with any dental treatment in our office.

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