Patient Forms


376 Dental Studio Patient Forms

Please click on the links below to access our online forms. Please complete the forms prior to your appointment. If you are unable to complete the forms, please plan to arrive 10-15 minutes early for your appointment so that you can complete them in our office.


COVID-19 Pre-Screening Questionnaire
Teledentistry Form

New Patient Forms


Patient Information
Medical History Form
Dental History Form
Insurance Information Form
Acknowledgment of Privacy Practices (HIPAA)
General Consent Form
Financial Policy
Communication Release Form

Record Release Form


Record Release Form