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    Bleach Special
    In office (Zoom) bleach treatment or customized bleach trays and take home bleach for $99!

    This offer can not be combined with any other special or insurance.
    Call our office to set up your appointment or complete the form below.

    Expires: 12/26/2018

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Patient Forms

For your convenience, we have supplied a Health History Form in pdf format.  If you wish, click on the link below, print, complete the form at home, and bring it with you to your first visit!  We look forward to greeting you!

Patient Information Form - .pdf (36K)

Health History Adult - .pdf (16k)

Health History Minor - .pdf (14.9k)

Online Patient Registration


 Adobe Acrobat Free Reader