Norristown: 610-631-3400
Conshohocken: 610-828-3400
Patient Paperwork (PDF)
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Patient Paperwork
If you’re a new patient coming to our office for the first time, you will be asked to fill out a couple pages of information. You can fill it out at the office if you show up 15 minutes early to your appointment, or you can fill it out online through our HIPAA secure web forms.
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Family Plan
No insurance? No problem! Here you can view a list of our in house dental fees for patients without insurance. The family plan comes with 2 cleanings, an exam, and x-rays every year for only $189.
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HIPAA: Notice of Privacy Practices
HIPAA (Health Insurance Portability and Accountability Act) protects your medical information and ensures data privacy for the patient. Here you can view the privacy practices for our office.
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Acknowledgement of Receipt of Notice of Privacy Practices
The law requires that we as a healthcare office notify our patients of how we may share or use your health information. This notice will also include your healthy privacy rights. You can ask for a copy of our privacy practices at any time.
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Records Transfer Form (Into Office)
If you are planning on leaving our office, we ask that you fill out a records transfer form so that we may begin the process of securely transferring patient notes and xrays to your new dentist. Click the link below to print and fill out your records release form.