New Patient Forms

Call (205) 933-1291

New Patient Forms & Resources

If you are a new patient to our office, the attached file below contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your dental needs more quickly than completing them on your arrival.  

Thank you and please call our office if you have any questions at all.


Print Complete New Patient Forms Bundle 

Single Forms available:

Patient Registration 

Medical History

Consent for Services

Non Covered Services

HIPAA Authorization

HIPAA Notice of Privacy Practices


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

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We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.
Complete Dental Care, PC
Email: frontdesk@completedental-al.com
Phone: 205-933-1291
Fax: 205-930-9029
Url:
2121 14th Avenue South
Birmingham, AL 35205
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