Patient Forms 2017-09-22T19:04:09+00:00

Patient Forms

 

Make An Appointment

To help minimize your time in the waiting room, please print out these forms, complete them, and bring them with you for your first office visit. If you are an existing patient, then it is not necessary to submit these forms again unless your health or personal information has changed.

All of these forms must be completed and on file at Ghareeb Dental Group before any treatment can begin.

 

 

Standard form for all locations that authorizes the Dentists and staff to access your health information in order to carry out your treatment.

Consent Form

Health History form for all location that details your health conditions, allergies, and any medical concerns.

Health History

General patient information form for all locations that details patient’s contact information and insurance information.

Patient Info Form

Financial and Dental Insurance Policy form for all locations stating you consent to pay co-pay and fees not covered by health insurance.

Insurance Policy Form