Patient Registration

Patient Forms

Please download these forms and fill them out at your convenience. Bring the completed forms to your office visit.

Please assist us by providing the following information at the time of your consultation:

• Any X-rays taken by a previous dentist — if not more than 3-months old, if applicable.

• A list of medication you are presently taking.

IMPORTANT: Please alert the office if you have a medical condition that may be of concern prior to treatment (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc) or if you are currently taking any medication (i.e., heart medications, aspirin, anticoagulant therapy, etc)

Completed Patient Registration forms MUST be received in our office prior to your visit so Dr Mehta can have the ample time to review all relevant health/dental history prior to be seen.

Please SUBMIT your registration forms as early as possible.

• Submit Patient Registration and Health Questionnaire;

• Once you receive an Automated TEXT message to confirm your appointment, It is important that you confirm your appointment so we know you will be here on your reserved time.

• If you are unable to make it to your appointment on the Date/Time reserved, please call us at least 48 hours prior to cancel or reschedule your appointment.