Patient Forms

Medical History Sheet

Oral Health Risk Factor Worksheet


Consent for Tooth Extraction

Consent for Root Canal Treatment

Consent for New Dentures

Consent for Immediate Dentures

New Patients

Patient Information / Medical History

Oral Health History

Financial Policy

Notice of Privacy Practices

Acknowledgement of Receipt of Privacy Practices

Consent for Use and Disclosure of Health Information

Dental Record Release Form
(to send past records to Jeffrey P Fish DDS)