Download our office forms from the convenience of your home to request records, x-rays, new patient forms and more.
We are in the process of becoming a paper-free office. Please be sure to provide your cell phone number and/or e-mail address in order to receive the most current appointment information, update
records, and contact staff.
We are currently using Solution Reach for our virtual Intake and Appointment reminders. You can now text our Hudson or Londonderry locations directly to communicate about an appointment,
request an appointment, make changes and updates.
New Patient Forms
New Patient Forms: Medical & Dental history, Financial Agreement, Cancellation Policy, Consent for Disclosure, Insurance Form, HIPAA.
NPA_Forms_updated2025.pdf
Adobe Acrobat document [511.2 KB]
New Patient Forms: Medical & Dental history, Financial Agreement, Cancellation Policy, Consent for Disclosure, Insurance Form, HIPAA.
NPA_Forms_updated2025.pdf
Adobe Acrobat document [511.2 KB]
Record Release from US
Use this form if you are transferring from our office.
Record_Release_from_NLD.pdf
Adobe Acrobat document [183.4 KB]
Use this form if you are transferring from our office.
Record_Release_from_NLD.pdf
Adobe Acrobat document [183.4 KB]
Record Request
Use this form if you are transferring to us from a previous dentist.
Record Request To Us.pdf
Adobe Acrobat document [114.5 KB]
Use this form if you are transferring to us from a previous dentist.
Record Request To Us.pdf
Adobe Acrobat document [114.5 KB]
Photo Release
Authorize New Look Dental to publish photographs, slides, and/or videos
Photo Release.doc
Microsoft Word document [87.0 KB]
Authorize New Look Dental to publish photographs, slides, and/or videos
Photo Release.doc
Microsoft Word document [87.0 KB]
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