Get Apple Tree Dentistry New Patient Forms.docx

Filling out the Apple Tree Dentistry New Patient Forms online is a straightforward process designed to gather essential information regarding your dental health and to facilitate your treatment plan. Follow the steps below to ensure that you complete the forms accurately and efficiently.

Follow the steps to complete your new patient forms online

1. Click the ‘Get Form’ button to obtain the form and open it in the editor for online completion.
2. Start with the patient information section. Enter your name (first, middle initial, last) followed by your address, city, state, and ZIP code. Provide your home, work, and cell phone numbers as requested.
3. Indicate your sex by selecting either 'Male' or 'Female,' and specify your marital status by choosing from the given options: 'Married', 'Single', 'Divorced', 'Separated', or 'Widowed'. Input your birth date and Social Security Number, and provide your driver's license details and email address.
4. In the emergency contact section, name an individual and provide their phone number. This person will be contacted in urgent situations.
5. If you have a responsible party for insurance (different from the patient), fill in the required details such as their name, address, and contact information.
6. Complete the primary insurance information section by entering the name of the insured, their Social Security Number, employer details, insurance company name, and group number. Also, specify the relationship to the insured and their date of birth.
7. If applicable, provide the secondary insurance information following the same format as the primary insurance details.
8. In the referral information section, indicate how you were referred to the practice, checking one of the provided options.
9. Proceed to the dental history section. Answer questions related to your dental health by selecting 'Yes' or 'No' where appropriate for each query regarding your dental visits, sensitivity, and treatment preferences.
10. Move to the medical history section. Respond to the questions regarding your medical conditions, medications, and any allergies you may have. Provide details as necessary.
11. Finally, read the acknowledgment statement regarding the accuracy of your responses. Then, sign and date the form to confirm your understanding and consent.
12. After completing the form, you can save your changes, download the filled form, print it, or share it as needed.

Start filling out your patient forms online today to ensure a smooth experience at Apple Tree Dentistry.