Patient Registration

We know that your time is valuable. That’s why we offer a simplified office experience with online patient forms that you can complete prior to your appointment. You’ll spend less time in the waiting area, streamlining your initial visit. These forms help us better understand your background, allowing us to provide you with the most effective care possible. As always, please do not hesitate to contact us if you have any questions about patient forms or your appointment.

• Welcome form REQUIRED
• Office Policies REQUIRED
• Adult Medical History​ Form REQUIRED
• Adult Dental History Form REQUIRED
• Pediatric Dental / Medical Information Form (12 years old and younger)
• Notice of Privacy Practices 
• Records Release Form to Coastal Dental
• Records Release Form from Coastal Dental
•  Privacy Terms Conditions

If you have any questions or concerns or need help filling out the forms, please call our office at Portsmouth Office Phone Number (603) 436-6997. We will be happy to assist you.