New Patient Forms

Please print and complete all forms listed below. You may mail them to office prior to your appointment, or bring them with you to your first visit. We look forward to meeting you!

Click below to download New Patient Registration Materials

New Patient Registration.pdf

AUTHORIZATION FOR RELEASE OF IDENTIFYING HEALTH INFORMATION.pdf

HIPPA CONSENT.pdf

Medical History.pdf

Consent for Payment and Fees.pdf

URGENT MESSAGE REGARDING COVID-19

Effective June 1, 2020 our office has implemented changes in our policies and procedures. Please CLICK HERE to review our new policies prior to your next visit with us

If you are new to our practice, and cannot get in touch with your general dentist for an emergency, feel free to call us. We are here to help you! (716) 668-9700

New Patient Specials

We offer new patient specials for cleaning, exam, X-rays, teeth whitening, dentures and more. Click here for more details!

Teeth Whitening Special

Check out our new Teeth Whitening Special, starting as low at $8.00! Click here to learn more