Patient Registration Forms
Below is a list of forms for Wellington Center for Laser Dentistry. Please print these forms and fill them out prior to your first appointment. Please make sure to bring them on your first visit to our office. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
- COVID-19 Screening Form
- Patient Registration
- Privacy Notice Acknowledgement
- Statement of Financial Responsibility
- Dental History
- Consent to Use Before and After Images
- Existing Patients Update Form
Please Click Here to Access Your New Patient Forms!
New Patient Forms
If you have any questions, do not hesitate to call us at Wellington Center for Laser Dentistry Phone Number 561-791-8184!