Registering online was designed for the convenience of our patients. This enables you to complete required paper work in the comfort of your home before coming into our dental office.

Each of the following pages contain information that will help us to get to know you so that we can better serve you. The process includes: a patient information form, dental and medical history forms.

The required fields are marked with a red asterisk and must be completed before submission.

Note: If you are a patient returning for a Doctor Examination following a previous hygiene visit, click on
"Returning Patient" to fill out Dental History Forms.

Secure Registration
Your online security is important to us. That is why we are committed to safeguarding your personal information online to keep it secure and confidential.

When you submit a registration form, your information is sent over the Internet from your computer to our server using Secure Socket Layer (SSL) technology. SSL encrypts your personal information before it leaves your computer, ensuring that no one else can read it.

Before submitting a form, check that your Registration session is secure in two ways:
· Look for the small padlock icon usually located in the lower right corner of your Web browser window. A closed, or locked, padlock indicates a secure connection.
· Look for the letters “https://” at the beginning of the Web site address or URL in your Web browser. The “s” means secure.