Beyer Dental Clinic Patient Registration

To make your visit to Beyer Dental office as convenient as possible, below we provide copies (in MS Word and PDF formats) of the forms you will need to fill out on your first appointment. You can print a copy at home and fill in the information at your convenience. Then just bring the completed forms with you to the dentist clinic for your appointment.

We need all three forms filled out. Please read the Notice of Privacy Practices before you sign Consent on the bottom of the Patient Registration form.

• Patient Registration Form ( MS Word | PDF)
• Patient Dental History Form ( MS Word | PDF)
• Patient Medical History Form ( MS Word | PDF)