"We take pride in caring for the whole person with compassion, understanding and a commitment to the better health of our patients. Our motivation is inspired by the love we have for what we do as it pertains to the care we give to others."
William R. Birdwell DDS

New Patient Forms

We have made our new patient forms available to you as Adobe Acrobat files. For your convenience, we recommend printing and completing these forms at home. If you have any problem getting these files to print properly, please call our office and we will gladly send or fax them to you.

 

We welcome new patients!  If you are an adult, please complete pages 1, 2 and 3.   If you are a college student, teenager, or child who has another responsible party, please complete pages 4 and 5.  Also, please click on the “Notice of Privacy Practices” below and download these forms as well, signing and dating them as indicated.  We request that you mail all forms to the office at least four days prior to your appointment.  If this is not possible, just bring the completed forms to our office when you come for your appointment.  For our patients with dental insurance please read the letter titled “To Our Patients with a Dental Plan” provided here.  Again, welcome to our practice!

 

New Patient Forms

Notice of Privacy Practices

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