Patient History Form
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Your First Visit
Arrival: It is important to arrive 15 minutes prior to your scheduled appointment time so we can ensure your information is ready for the doctor.
What to bring:
· The completed patient history form.
· Your most current dental insurance card, if you have been issued one.
· X-Rays from your previous dentist are encouraged. Please request they be sent to
us via mail or email address listed to the right.
If you need to reschedule or cancel your appointment for any reason, please give us a call at least 24 hours before your scheduled visit. If you haven’t already, schedule your appointment here.
Co-pays, deductibles and all related fees for your visit are due at the time that services are rendered. We accept all major credit cards, check, money order, cash and Care Credit. For detailed financing and insurance information go here.
For their first visit, minors MUST be accompanied by their parent or legal guardian. The person who brings the minor to their visit is financially responsible for all costs due that day.
We look forward to seeing you soon!
Dr. Gregory Abbott, DDS
Dr. Bom Dokko, DMD
Dr. Gary Haraszthy, DMD
Dr. Ronald Sadler, DDS
Dr. Michelle Lewis, DDS
Dr. Amy Bowman, DMD, MS
Dr. Doralee Greenberg, DDS
Dr. Lisa Mruz, DDS
Dr. Kati Hetrick, DDS
Dr. Jennifer Holmer, DDS