top of page

New Patient Info

Please help us be prepared for your first appointment by completing the following information. Just click on each link to download the forms, print them and complete them at home. You can then e-mail them (office@longlakedental.com), fax them (1-844-227-5345) or simply bring them with you to your first visit.
We look forward to meeting you soon!
Patient Registration and Medical History
Consent for Use & Disclosure of Health Information
Record Release to Our Office — please note this form needs to be filled out and sent to the patient’s previous office.
Financial Guideline
bottom of page