ToothFillers is going digital! We are reducing paper use in order to reduce waste, while making it easier and faster to correctly capture your information. When you visit us in the practice we will provide you with a kiosk to complete all the required forms digitally, but if you feel more comfortable we can always provide you with a paper form as needed.
- Registration Form
- Medical History Form
- HIPAA
- Financial Agreement
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COVID-19 FORMS
- Consent for Emergency Treatment During COVID-19 Outbreak
- Covid-19 Patient Screening Form
- Formulario de evaluación del paciente Covid-19
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- Patient Referral Form (for referring Dentists, Doctors and Offices)