Patient Forms
Going to the dentist can be an overwhelming experience, especially on your first dental visit. Let us put your concerns and anxieties to rest. Our goal at Roman Shlafer, DDS is to make every patient experience as comfortable as possible.
To make your visit as pleasant and brief as possible, there are a few things you should bring with you. Please bring any dental X-rays from the last six months to your first appointment.
With just a few simple forms, we’ll ask for relevant medical history, any medications you might be taking, your dental history, and any dental insurance coverage you may have.
Want to get a head start? Download the new patient forms below.
- Dental History Form
- Medical History Form
- Dental and Medical Patient Form (Russian)
- Dental Insurance Info
- Patient Acknowledgement Form
- Patient Registration Form
- Privacy Practices Form
These documents are in Adobe PDF format. If you’re unable to read PDF files, please download free Adobe Acrobat Reader here.
Yvonne Miller
Marc B.
Christiana H.