At Main Street Smiles we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.
- You will need AdobeReader® to download and complete the forms. Click here to download.
- Download the required form(s). Print out the form(s) and complete the required information.
- Fax your printed and completed form(s) to our office or bring them with you to your appointment.
New Patient Health History Form – Required
Please complete this form as it lets us know the history and current state of your health: Download & Print Form
Patient Registration: Download & Print Form
Financial Policy: Download & Print Form
Notice of Privacy Practices: Download & Print Form
Authorization for Release of Information and Notice of Privacy Practices: Download & Print Form