New Patients

Welcome to DeSanti Family Dentistry. Thank you for selecting our dental healthcare team. As part of our mission, we will provide you with the highest quality of oral health. In order to help us begin to meet your oral healthcare needs, please download and print the following documents. Please fill out ALL of the required information and bring the documents to the Reception Staff at your initial visit.

Patient Information
HIPAA Omnibus Rule: Acknowledgement, Consent, & Release Form
Notice of Privacy Practices
Conditions of Treatment and Consent for Services
Medical History
Dental History
Consent to Discuss Treatment
DeSanti Family Dentistry Financial Agreement
DeSanti Family Dentistry Dependent Young Adult Financial Consent

Other Patient Forms

Post-Dental Cleaning Instructions
Post-Operative Instructions (Crowns, Fillings, Bridges, Veneers)
Post-Surgical Instructions
Take-Home Teeth Whitening (Bleaching) Protocol
TMJ Dysfunction Homecare Instructions
Rx Colgate Prevident 5000 Sensitive Instructions