Here are the forms you will need for your first appointment.
- Welcome to Duxbury Dental Associates
- Patient Registration & Medical History Form
- Office Policies
- Informed Consent for General Dental Procedure (2 pages)
- Acknowledgement of Receipt of Notice of Privacy Practices
- Notice of Privacy Practices (3 pages for you to keep)
- New/Change of Insurance Form
- Release of Records from Duxbury Dental Associates
- Request for Release of Records to Duxbury Dental Associates
Please be sure to review, sign and date the above mentioned forms and bring with you to your first appointment.
Again, Thank You for choosing our office to provide your dental care. We look forward to building a long, healthy relationship with you and your family.
The Staff of Duxbury Dental Associates