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1-845-DENTIST

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Insurance Information Form
New Patients and Existing Patients that have dental insurance are required to complete this form at the start of their treatment and every year thereafter. Changes to insurance will also require this form to be updated accordingly. Please complete this form and bring it with you to your appointment.

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Adult Health History Form
New Patients and Existing Patients over the age of 13, please complete this form and bring it with you to your appointment. (Existing patients need only to complete this form if it has been more than a year since your last appointment).

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Child Health History Form
New Patients and Existing Patients age 13 and under, please have a parent or guardian complete this form and bring it with you to your appointment. (Existing patients need only to complete this form if it has been more than a year since your last appointment).

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Our forms are in Adobe PDF format. If you do not already have the free Adobe Acrobat Reader, you can download it here.
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370 Kings Mall Court, Kingston, New York (NY) 12401
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