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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.