Forms //

To complete the COVID-19 survey follow the giant button below, do not fill out the new patient forms.

First time patient? Or, haven't seen us in a while? Please complete our online forms to pre-register for your appointment. If you have dental insurance, please make sure to include that information, or email a photo of the front and back of your card to office@closurdofamilydentistry.com. This will allow our staff to provide you with estimated patient payments based on your insurance plan. 

Below is a link to our office HIPAA policy and patient agreement. You can print these for your records. You will have a chance to complete them using the electronic forms link above.