Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom. You should see a “Thank You” that means that the information was successfully automatically sent to us. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Patient Registration

Please review the following prior to completing the registration paperwork:

Pharmacy Information:

  • Please include the pharmacy name, address and actual number to the pharmacy not just the store.
    • *Missing information could cause a delay in your prescription*

Insurance Section:

  • We need the information of the person who carries the insurance.
    • *Which might not be the patient*
  • If you carry Delta Dental insurance, please include the state associated with your policy. 
    • *Missing information could cause a delay in processing claim*
  • *Please bring your insurance cards and photo ID to your appointment so we can make copies.

Below are the instructions for patients having IV Sedation / General Anesthesia as well as after-care instructions for all patients having surgical procedures.