Patient Registration

If you are a new patient, you will be asked to come about 15 minutes early to fill out some paperwork before your appointment. This includes a Health History Form, and an acknowledgement of the HIPAA privacy act. If you would like, download and print the Health History Form below to fill out before you come to our office to save some time.

Southwest Endodontics & Periodontics Health History Form*
+ Download PDF (68kb)