Forms

NEW PATIENT FORMS:

Please print, fill out and bring these to your appointment.

  1. Medical History Form: Medical History Form
  2. HIPPA Form: HIPPA Policy Form
  3. Patient Consent: Patient Consent Form
  4. Financial Policy: Financial Policy

PATIENT TRANSFER FORMS:

If you would like your x-rays transferred to or from our office you can download the form below.

To transfer x-rays from Saint Michael Dental Center to another provider:X-Ray Request Form To Provider

To transfer x-rays to Saint Michael Dental Center from another provider: X-Ray Request Form

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