Patient Forms

Our p
atients are seen on an appointment basis. We reserve time specifically with you and Dr. Jennifer H. Diaz  or one of  her skilled periodontal  hygienists. We ask that you complete an online appointment request or call in advance so that we may provide an appointment time for you.

If you are a new patient to our office, the link below contains some  forms that will need to be filled out when you arrive at our office. Printing forms, filling them out and bringing them with you will allow us to attend to your periodontal  needs more quickly than completing them on your arrival. 

We welcome you  and thank  you for the opportunity for allowing us to care for you, your family members and friends. Please contact our office if we can be of further assistance.


New Patient Forms


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