Village Dental Forms

Each new patient will need to complete the New Patient Form upon arrival for their first visit. For your convenience, you can download the New Patient Form by clicking the link below. You can right click the form, and select Save As from the menu to save the form to your desktop. Once the form is saved, you can open it using Adobe Acrobat Reader.

The New Patient form can be printed and filled in manually for you to bring with you on your first appointment or, you can fill in most of the form using Acrobat Reader and then print it. In either case you will need to sign the form at our office in the presence of our receptionist.

If you do not have the free Adobe Acrobat Reader on your computer, you can get it by clicking HERE or by clicking the Adobe Acrobat logo image above. This link will take you to the download page of Adobe's website for Acrobat Reader. Before you download the program, make sure you notice the download options and select only the options you desire. For example, there is an optional additional program for McAfee anti-virus software on the same page, the ckeck box to download it is checked by default. If you do not want this additional software, simply un-check the box before you click on the download button.

Download the New Patient Form HERE

Village Dental Financial Policy Form

The Village Dental Financial Policy Form is also required when you arrive for your first visit. You can click on the title of the form above to download it to your computer or get it by clickking HERE.

If you need assistance completing the forms we will be happy to do so when you arrive. We provide the forms for you on our website for your convenience, and we have the forms ready for you at our office as well.