New Patient Forms
 

 

 

New to Legacy Dental?

Thank you for choosing our practice for your oral health needs. We look forward to meeting you and will strive to make each visit to our office a comfortable, pleasant experience.

Your first visit will include a full mouth x-ray, a thorough oral exam, an oral cancer screening and possibly a cleaning. If you have been having regular preventive dental treatment, your cleaning will probably take only one visit. If not, you may have gum inflammation with tartar buildup which might require you to have subsequent visits. After your exam, we will design an individual treatment plan based on your needs and wants, and will explain the plan in detail.

For your convenience when visiting our office, please print the following forms, complete the information and bring them with you to your first visit...


New Patient Health History Form - Adult

New Patient Health History Form - Child

Financial Policy

Privacy Policies & Procedures - HIPAA (Read Only)

HIPAA Acknowledgment of Notice

Smile Reminder

 

Make an appointment

 

To print the form you will need Adobe Acrobat Reader. If you do not have Adobe Acrobat, please click here to download it for free to your computer.