Patient Information

SAVE TIME! DOWNLOAD,PRINT AND FILL OUT YOUR NEW PATIENT FORMS AT HOME

For your convenience please download each form, print it out and fill out at home at your leisure. Also remember to bring any x-rays that less than 2 years old.

Patient Forms

• Patient Registration
• Medical History Main Report
• HIPAA Patient Consent Form

Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader logo.

Insurance & Financing

Dentistry should not be a financial burden for anyone. Distinctive Dental offers payment options including Care Credit.

• 12 Months Interest Free Financing
• Extended Financing from 18-60 Months

Distinctive Dental Accepts many insurances and will gladly bill your insurance for you.