If you are a new patient to our office, you can print and complete the following first 4 forms to save you time before your first appointment.
- Patient Information Form (94k PDF) 1 pg.
- Patient Medical and Dental History Forms (256k PDF) 2 pgs.
- HIPAA (Health Insurance Portability and Accountability Act) (877K PDF) 2 pgs. By signing this form you signify that you have been informed how information about you may be used and disclosed, and you are assured that we protect your personal privacy as required by federal and state laws.
- Informed Consent for dental procedures 1 pg. Please initial all the marked areas and complete by signing and dating at the bottom.
- Record release for former Dr Landry patients 1 pg. Please complete by signing the bottom, and return the original form to us. We will take care of the rest, and look forward to meeting you!
- Records Release TO us. If you are joining our practice, “Welcome”! Please download this form requesting your previous dentist to forward your records to us. Once it is signed, you can mail it to them, or we can fax it on your behalf.
- Records Release FROM us. If you are moving, we can provide copies of your record for the new dentist. Once this form is signed, return it to us, and we will make copies and forward them to the designated dentist.