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.
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]
Print