We take pride in our comfortable waiting rooms, but we don’t want you to have to wait too long. For your convenience, we have provided the following forms that you can fill out before your visit. You must have a PDF reader. You can download the Adobe PDF Reader by clicking the link below. Please make sure you read the Notice of Privacy Practices, then print out the Acknowledgement form. We ask that you please sign that form and bring it with you, along with the other signed forms, at the time of your appointment.
Wasilla Patient Forms
- New Patient Form
- Consent For Use And Disclosure Of Health Information Form
- Financial Agreement And Authorization For Treatment
- Signature On File Form
- Consent to Discuss
- Authorization To Release Dental Records
Click this link below to download and view our HIPAA Notice of Privacy Practice.