Patient Forms

Please click on the links below to see downloadable Adobe PDF versions of our office forms. You most likely already have this software on your computer. If you have difficulty accessing these forms, please click here to install Acrobat Reader.

Patient Registration Form/Health Questionnaire: To expedite your initial appointment, please complete this form (along with a list of all medications you are currently taking) and bring it with you to our office. It is critical that this form be completed accurately to ensure that Dr. Priest and dental team are aware of all medical conditions prior to treatment.

Request for Dental Records: Patients can download this form to authorize the transfer of records/x-rays to Dr. Priest’s office.

HIPPA Privacy Policy: This form presents the information that federal law requires us to give our patients regarding our privacy practices.

Dr. Referral Slip: Referring Doctors can download our referral slip to provide us with information about the patient and his or her dental condition.

Informed Consent Forms: These forms explain what patients can expect during treatment and answers the most commonly asked questions.

Post-Op Instructions: These forms contain instructions to be followed by patients completing treatment.

Permission to Use Full Face Images: Dr. Priest is involved in providing continuing education to other dentists. He may request that you provide permission to show your face in pictures presented in clinical presentations. You are not obligated to provide this permission.

Patient Feedback Questionnaire: We would appreciate your constructive feedback on the quality of services you received at our office. Please click on the following link to download the Adobe PDF version of our Patient Feedback Questionnaire You most likely already have this software on your computer. You may also complete the electronic form of our Patient Feedback Questionnaire to submit your comments and suggestions anonymously.