|
Downloadable Patient Forms
Bright Smiles Dental has made the following patient forms available below.
These forms may be downloaded and filled out prior to arriving at our office for
your convenience. The forms are available in Adobe® Reader® (.PDF) format. If
you do not have Adobe® Reader®, click the icon at the bottom of the page to download it for free.
|
Patient Information Form
This form provides Bright Smiles Dental with patient contact information, in addition
to insurance information and basic medical and dental history.
|
Download Patient
Information Form
|
|
HIPPA Privacy Notice
This standard notice of privacy describes how health information about you
may be used and disclosed and how you can get access to this
information.
|
Download HIPPA
Privacy Notice
|
|
Financial and Appointment Policy
This notice discloses Bright Smiles Dental's policies regarding customer payment
and co-pays, appointment cancellations, and account
balance collection.
|
Download
Financial Policy
|
|
