Patient Registration

We have stream-lined your paperwork to make it as simple and easy for each patient to register as possible, but it will still take a few minutes to complete.  We ask that you arrive 15 minutes prior to your scheduled appointment to be able to fill out the required paperwork, to make payment and to get situated prior to your root canal treatment or consultation appointment.

Call Us With Any Questions, We are Here to Help!  (931) 553-8484

Below you can find Hyperlinks to access our new patient paperwork including: notices of HIPAA (Privacy Practices), our Health History Form, our Financial Policy, our Endodontic Consent Form, and our COVID-19 Release Form. Please print these, fill them out, and bring them with you to your patient appointment. We look forward to seeing you!

HIPAA Notification.doc

Health History Form

Financial_Policy_Signature

Endo Consent Form

COVID-19 Form

Call Us With Any Questions, We are Here to Help!  (931) 553-8484