Call:(845) 473-1212
Patient Forms

If you are a new patient to our office, the forms below will need to be filled out and returned to us before you arrive for your first appointment in our office. Please fill them out completely and then send, fax or email them to us. We will contact you to set up your first appointment as soon as the completed forms are received. Thank you and please call our dental office if you have any questions or need any assistance. 

Patient Health History 

Consent for Treatment

HIPAA Privacy Notice (Sign and return page 5)

COVID Patient Consent.doc

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.