Patient Forms

Picture of a patient giving a thumbs upSave time and complete the Patient Medical Form and HIPPA Form in advance. These patient forms are in PDF format.

If you do not have Acrobat Reader installed, you can download it here.

When you have Acrobat Reader just print the form, fill it out and bring it in on your first appointment.

Here are the forms for download:

The HIPAA form allow you to give us the permission to release needed information to your dental insurance or dental care plan required for payment for our services and to other healthcare professionals for your care.

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561-627-2399
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561-627-2399 or info@drbraichdentistry.com