Before Your First Appointment

Please complete the following forms before your first appointment. We ask that you arrive 10 minutes prior to your scheduled appointment to allow time to sign paperwork. Thank you!  

Patient Registration and Medical Dental History

Click on the button. Fill out each form listed on left-hand side. Press the "submit" button upon completion.

Authorization to Release Dental Records (PDF)

Please print, sign, and email to office@penzdental.com.

Notice of Privacy Practices (PDF)

First, please read the Notice of Privacy Practices. Next, print the signature page, sign, and email to office@penzdental.com.

Financial Policy (PDF)

Please print, sign, and email to office@penzdental.com.