Scott D. Beallis, D.D.S., Ltd.
Creating Beautiful Smiles

Patient Forms

Patient Registration Form - New patients or patients with changes to their personal information.


Medical/Dental History - New Patients or patients with changes to their health or dental history.


Office Policy - New Patients, please read and sign


HIPAA PRIVACY PRACTICES - New patients, please read, save a copy if desired.


HIPAA Form - New Patients, patients who are over 18 years of age.