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Some of the new patient forms are in Adobe Acrobat (PDF) format.
If
you do not have Acrobat Reader, get a free copy by clicking on the icon here
>>>>>
Click on the link to download the forms. Then print the forms, fill them out, and bring them with you on your first visit. Also, after reading the Notice of Privacy Practices, print the Acknowledgement form below, sign it, and bring it in, too.
Patient
Info and Health History (Acrobat PDF)
Financial
Responsibility Form (Acrobat PDF)
Acknowledgement of Receipt of Notice of Privacy Practices (web page)
Healthcare
Creditline Application (Acrobat PDF)
Click here to apply online for CareCredit.
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© Copyright 2001- Dental WebSmith, Inc. and Craig C. Pettey, DDS, Inc. All rights reserved. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.
