new patient paperwork
Please complete the following two documents and email them to us at ballarddentalcare@gmail.com prior to your first appointment.
Patient Registration.pdf
Adobe Acrobat document [330.5 KB]
Adobe Acrobat document [330.5 KB]
Financial Privacy Policy.pdf
Adobe Acrobat document [1.8 MB]
Adobe Acrobat document [1.8 MB]
If you have current records at another office, please fill out and send this release form as well.
Records Release Form.pdf
Adobe Acrobat document [257.0 KB]
Records Release Form.pdf
Adobe Acrobat document [257.0 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 on their paperwork so that we can personally thank you. We'll also send you a $25 gift card to show our appreciation after their new patient exam, x-rays and cleaning.
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