Forms

Simplify your dental visit

Fill-out new patient forms, update patient and health information or get consent forms. You may fill-out and send forms securely online or download, fill-out, print and bring them to your appointment.

New patient forms

Want to establish yourself as a new patient with Douglass Family Dentistry? Complete your intake forms today.

Update your current information

Changes to your address, insurance or medical history? We will be happy to update your information for you.

Authorization for release of information

Need us to request your records from a previous dental office? Fill out the HIPPAA authorization for release of information form and we will send your request. 

Authorization for Physican release

Do we need to consult with your medical doctor prior to treatment? We can send a request before your next appointment.

Send My Forms Documents Securely

Want to be ready for your next appointment?  Upload your paperwork and we will be happy to verify your benefits and get you ready for your dental visit.

New Patient Forms

All the forms you will need for your initial dental visit.  You may also send us a copy of your insurance card so that we may verify your benefits prior to your visit.

Record Request

If you have records at a previous dental office, this form can be used to request them on your behalf.

Physician release form

If an authorization is needed from your medical doctor prior to treatment, this form can be used to authorize treatment.