new patient paperwork

New patient? Please download and fill out the following forms when you come in for your first appointment. If you are not able to, plan to arrive 10 minutes early to complete them prior to your scheduled appointment time.

Patient Medical History Form

This form is mandatory for new patients. To expedite your visit, print this form, fill it out and bring it with you for your first visit.

Patient Medical History Form
Patient Registration.pdf
Adobe Acrobat document [60.3 KB]

Privacy Notice and Financial Policy

Please read over and sign our Notice of Privacy Practices, acknowledging our privacy policy, as well as our office financial policy. These forms should also be brought to your first appointment.

Privacy Notice
Privacy Policy.pdf
Adobe Acrobat document [108.2 KB]
Financial Policy
Financial Policy.pdf
Adobe Acrobat document [116.2 KB]

Your smile is an investment for a lifetime!


The greatest compliment our patients can give is the referral of their friends and loved ones.


Refer a friend or family member to us and be sure they mention your name so that we can personally thank you. We'll also send you a $25 gift card to show our appreciation.

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Ballard Dental Care
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