Patient Forms

NEW PATIENTS

If you are new patient please complete the following forms to expedite your initial visit at CopperMine Dental Studio:

1.  Registration and Health History | Download (pdf) 

2.  HIPAA Privacy Form | Entire Download (pdf) - Print last page only

3.  Financial Policy Form | Download (pdf)

 

ORTHODONTIC PATIENTS

1.  Orthodontic Patient Questionnaire | Download (pdf)

2.  Orthodontic Consent to Treatment | Download (pdf)

 

EXISTING PATIENTS

1.  Release of Records Form | Download (pdf)