Patient Registration

Please take a moment to print and complete our Registration documents.  It is very important that we have this information at the time of your upcoming visitPlease arrive at least 15 minutes early  for your appointment.  You should make sure to fill out the enclosed medical history, with as much detail as possible, and provide us with all your insurance information (i.e. medical (including Medicare) and dental insurance).  

Make sure to either bring the completed documents with you to your scheduled appointment, fax to 609.654.0040, or email at [email protected]  By providing our office with the necessary documents ahead of time, you will help to speed the process at check-in time.

All patients under the age of 18 must be accompanied by a parent or guardian at the consultation visit.

In addition, please bring the following:

  • Recent x-rays that pertain to your treatment (taken within the last year).  If your dentist or physician has taken x-rays, you may request that they forward them to our office to [email protected].  If there is not enough time, please pick them up and bring them with you to our office on the day of your appointment. If additional x-rays are necessary, they can be taken at our facility.
  • Surgical note from your referring dentist, orthodontist, or physician
  • Medical insurance referral, issued by your primary care physician for seeing a specialist, if required by your specific medical insurance plan
  • Medical and Dental insurance cards
  • Driver’s License

Registration Documents