Patient Forms

Patient forms help us get to know you better and collect the right information to more efficiently and effectively deliver proper dental treatments. Below you’ll see a list of forms for either New Patients or Returning Patients sections that can be expanded. Please fill out, print and bring the forms with you to our office or you can hand write the paper forms in our office.

New Patient Registration

New Patient Dental & Medical History

Office Policy

Patient HIPAA Awareness

HIPAA Patient Communication Form

COVID-19 Screening

Medical History Update

COVID-19 Screening

Request Appointment

The first step toward achieving a beautiful and healthy smile.

$250 Dental Cleaning, X-rays & Exam

Normally $500

For a limited time, you can take advantage of our discounted offer of $250 for a dental cleaning, x-rays & exam. That's $250 vs $500. For more information, click here.

Lux Smiles NYC Dental Cleaning Xrays Exam Promo

Our response to COVID-19Read More
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