New Patient Forms

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Appointment

The first step towards a beautiful, healthy smile is to schedule an appointment. Please contact our office by phone or complete an online appointment request.

Patient Forms

We are very pleased to welcome you to Kennebec Valley Dental Arts. We want you to know that we appreciate the opportunity to take care of you and your family. Our office is focused on providing you with high quality dental care that is affordable.

During your first visit Dr. Patten will examine your teeth, perform a comprehensive oral exam, take and review necessary x-rays, and make an assessment of your oral condition. At your first visit you will meet several members of our team.

If it is discovered that you need any dental treatment, a treatment plan and estimate will be prepared for you. Any questions regarding insurance benefits or costs will be answered prior to the beginning of any procedure. You will have the chance to review the recommended treatment and ask any questions you may have.

Below you will find a Patient Registration Form, a Medical History Form, a New Patient Questionnaire, and please review our Hipaa Notice of Privacy Practices documentation listed below. Please bring the completed forms to your first visit to ensure minimal wait time.

Patient Registration (Click To Download)

Medical History(Click To Download)
 
New Patient Questionnaire (Click To Download)

HIPAA Authorization and Aknowledgement (Click To Download)
 

The below forms are not required unless specified by our office:

Mouth Guard Consent (Click To Download)(Mouth Guard Patients)

Notice of Privacy Practices (Click To Download) 
 

 

Payment Options

To learn more about the different payment options available to you visit our Financial Options page. Feel free to contact our office if you have any questions or would simply like to further discuss your options.

LOOK YOUR BEST

We combine experience with the latest in dental technology to deliver the best patient experience possible.

Testimonials