Important Dental Office Forms
Dental patients can fill out the necessary forms and research answers prior to visiting the office.
Dr. Violette offers the following office forms for downloading and printing:
New Dental Patients
Patient Information Form
Our patient info form is used to collect general information about each patient for our files
Medical-Dental Profile
This form is used to establish a dental patient's medical history
Patient Office Policies
Used to inform the patient of the various financial & cancellation policies of David P. Violette, D.D.S., P.C.
Existing Dental Patients / Miscellaneous
Caries Risk Assessment & Treatment Options
Form used for classifying re-care patients
Employee Application
Application for prospective employees of David Violette, D.D.S.
Financial Arrangements
Used to establish the patient's payment arrangements
General Consent Form
Form used to verify a patient's consent for certain procedures
Notification Of Periodontal Disease
Used to discuss treatment options with patients having periodontal disease
Patient Satisfaction Survey
Patients can use this form to provide feedback on their experience in our office (online feedback form available here)
Three Month Re-Care
Form used to schedule a visit three months after initial periodontal disease treatment
Xylitol Information
Learn about the benefits of xylitol – reducing acidity in the mouth, pH balance restoration, and remineralization of tooth enamel
Having trouble viewing the above forms? Download Adobe Acrobat Reader here.
