Patient Forms

Please take a minute to fill out our patient forms in one of two ways.

To fill out online click the following link:

Online Patient Forms

To print, fill out and bring with you to your first appointment, click on each of the five PDF links below.  *Please note, if you do not have dental insurance, you do not need the Insurance Policy form.

  • Health Insurance Portability and Accountability Act of 1996 (HIPAA) PDF
  • Medical History PDF
  • Patient Information PDF
  • Financial Policy PDF
  • Insurance Policy PDF

If you’re unable to open PDF files, you can get Adobe Reader® for free.

We proudly serve the areas of Crawfordville, Tallahassee, Monticello, Quincy, Marianna, Carrabelle, and Perry

office Hours

Mon8:00am to 5:00pm
Tue8:00am to 5:00pm
Wed8:00am to 5:00pm
Thu8:00am to 12:00pm; Afternoon By Appointment Only
Request An Appointment
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