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Patient Forms

To complete your forms online, please click the button below:


To print your dental patient forms only, click the links below:

New Patient Forms | HIPAA Policy | Records Transfer

 

For Sleep Apnea patients only, please download the forms below, fill them out, and email them back to Dr. Cross at crossdentistry@verizon.net :

Notice of Privacy Practices | Informed Patient ConsentMedical Records Release Form

Epworth Sleepiness Scale  | Comprehensive Health History Questionnaire | CPAP Intolerance Affidavit


 

It is crucial that we have a complete medical history including current medications & reasons for use


 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.