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Forms

Welcome to Blakeslee Dental!  Thank you for selecting our office for your needs.  We take pride in our ability to provide our patients with the highest quality dental treatment in a warm and caring environment.  Your new patient visit will be approximately 1 1/2 – 2 hours long and may include the following:

* A comprehensive examination

* Any necessary diagnostic films to properly diagnose and plan for your lifelong oral health and comfort

* Prophylaxis (cleaning)

Please complete the attached forms and bring them with you to your first appointment.  We are looking forward to meeting you!

Patient Registration Form

Medical History

Hippa Privacy Practice Form

Family HIPPA Form

HIPAA Consent Form

Release of Information