Patient Forms

Below, you will find a listing of required forms for both new and returning patients.  Click the name of each form to view and then print a copy of it out.  Please bring the completed forms in with you on your next office visit. 

• = indicates for New Patients              

* = indicates for Returning Patients

• Patient Information & Health / Dental History

• Responsible Party Information

• New Patient Research Form

• Smile Analysis

• * Consent for Use and Disclosure of Health Information

• * Notice of Privacy Practices and Acknowledgement of Receipt

Dr. DeLapa'a forms are in PDF format, which may require Adobe Reader to view.

Please Click the button below to download the latest version from Adobe.