Patient Forms

Patient Forms


Please take a minute to print and fill out the patient information form before your first appointment:


  • New Patient Form (Adult) PDF


Please view our Patient Privacy Policy below:


  • HIPAA Notices (english) PDF (spanish) PDF


CoVid-19 related forms:


  • Statement on CoVid-19 PDF
  • Emergency Dental Treatment Consent Form PDF
  • Supplemental Health Questionnaire & Consent Form PDF

 For your safety and the safety of those around you:














If you do not have dental insurance and are interested in enrolling in our Brunswick Dental Care Membership Discount Plan, or if you are looking to supplement your current insurance plan, please check out our enrollment form below.

  • BDC Membership Plan PDF


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