New Patient Forms

The New Patient form is in PDF format. Click on the link to download the form.

Then print the form, fill it out, and bring it with you on your first visit.

If you do not have Acrobat Reader, get a free copy by clicking on the link below.

In addition to the form above, please read our Notice of Privacy Practices and then print and sign the Acknowledgement of Receipt of Notice of Privacy Practices. Bring it with you on your first visit.

© Copyright 2002- Dental WebSmith, Inc. and Christopher P. Toomey, DDS, PA. All rights reserved worldwide. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.