Office Downloadable Forms

New Patient Forms

Adult Patient	Download
Child Patient	Download
Financial Agreement	Download
Notice of Privacy	Download
HIPAA	Download
Records Release	Download

New Patient Forms

Adult Patient	Download
Child Patient	Download
Financial Agreement	Download
Notice of Privacy	Download
HIPAA	Download
Records Release	Download

Post-Op Forms

Extractions Post-OP	Download
Instructions for Daywhite Whitening Gel	Download

Call The Office



(480) 900-1733

(480) 867-1727

Office Location



11390 E Vía Linda #104, Scottsdale, AZ 85259



Monday - Thursday: 9:00am - 5:00pm

Friday - Sunday: Available For Emergencies