If you are a new patient to our office, the attached files contain our new patient forms that will need to be filled out when you arrive at our Benton dental office. Printing them, filling them out and bringing them with you will allow us to attend to you more quickly than completing them on your arrival. Thank you and please call our office at (501) 778-7129 should you have any questions at all.
NEW PATIENT FORMS
NOTICE OF PRIVACY PRACTICES
ACKNOWLEDGEMENT OF NOTICE OF PRIVACY PRACTICES
AUTHORIZATION FOR RELEASE OF IDENTIFYING HEALTH INFORMATION
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
As dental professionals it is our priority to provide quality dental care you can trust.