New Patient Forms
Download and complete your Valley Family Dental new patient forms before your first visit so your appointment starts on time instead of in the waiting room.
Fill these out at home and save yourself twenty minutes
Nobody enjoys filling out a medical history on a clipboard in a waiting room while the appointment they scheduled ticks away. Complete these before you come in and we can start on time.
If you would rather do it here, that is fine too. Just arrive about 20 minutes early and we will get you set up.
What you need to complete
- Patient Information — contact details, responsible party, and how you heard about us
- Medical History — conditions, surgeries, allergies, and a current medication list
- Dental History — your past care, what has worked, and what you would change
- Notice of Privacy Practices Acknowledgment — required by HIPAA
- Financial Policy and Consent — how billing and insurance work here
What to bring with you
- Your completed forms
- A valid photo ID
- Your dental insurance card, if you have coverage
- A current list of medications and dosages
- Any dental X-rays taken elsewhere in the last two years
- Your questions, written down so you do not forget them at the chair
If you had recent X-rays at another office, ask them to send the images over before your visit. It saves you radiation exposure and saves you money.
If the forms give you trouble
Call us. Our front office can walk you through any question on the form, and if downloading and printing is a hassle we will get you sorted another way. Nobody should skip a dental visit over paperwork.
Common questions.
Do I have to complete these before my appointment?
No, but it helps. If you arrive without them, plan to come in about 20 minutes early and complete them here.
What if I do not know all my medications?
Bring the bottles, or a photo of the labels on your phone. That is usually easier than trying to remember names and dosages, and it is more accurate.
Do I need forms for my child's visit?
Yes, one set per patient. A parent or legal guardian needs to complete and sign for anyone under 18, and that adult needs to be present at the first visit.
Can I email my completed forms?
Please do not email health information. Bring them with you, or call and we will arrange a secure way to get them to us.
Request your appointment.
Four questions. Our care team calls you back within one business day. If you are in pain right now, call the office directly and we will get you seen.