FORMS 

As a new patient in our office, in order to serve your needs with the best care possible, we require the collection of personal, medical and dental information. We are committed to protecting the privacy of our patients’ personal information and utilizing all personal information in a responsible and professional manner. 

We kindly ask that you arrive 15 minutes prior to your appointment to fill out the forms below, or save time by printing them off at home and bringing them along, you are also welcome to pick up your forms from the clinic prior to your appointment if you are not able to print them from home. If you are a new patient at our clinic or have recently been seen at another clinic please, call your previous clinic and have your x-ray and file transferred prior to your appointment, this will help us assist you in a more timely manner on the day of your visit.

We offer assistive Billing Services for private benefits programs. This means that you pay at the time of your visit and we handle the paperwork electronically. We handle and send the forms and documents on your behalf for all basics treatment done. Payments from Benefits programs usually take 12-48 hours to reach the patient.

WE REQUIRE A MINIMUM OF 36 HOURS NOTICE FOR CANCELLATIONS OR RESCHEDULING APPOINTMENTS

medical history 

The following form outlines the history of your general well-being, we believe at Unity Dental that the mouth is connected to the whole body. By having an idea of your general health, we can give you the proper care, referrals, and prescriptions needed when you come visit. 

Dental History

The following is form encapsulates the story of your dental health, it allows us to target underlying issues that you may not be aware of. It is the road-map of your appointment and allows you and the dentist to have a conversation that is meaningful and efficient.