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Forms

If you are a new patient to our office, please fill all 5 of these forms out, complete them and bring them with you upon arrival to your first appointment.  This will facilitate the initial process and save us a lot of paperwork time, so that we can concentrate on your dental needs.  If you have any question in filling these form please do not hesistate to call our office at (702) 456-0056.  Each individual needs a packet of 5 forms for him or herself.

These forms are fillable from your computer except for a few areas that require signatures.  If you don't have a printer at home, please fill them out, save them and email them back to our office at miracledentalnv@yahoo.com.  We will be gladly to print them out and you can sign them once you arrive in our office.

Welcome to our office  

Heath Questionaires

Informed Consent for Xrays and Exam  (Please put an X on the Xrays and exam box.  Initial the first 3 sections and sign at the bottom of the page )

Office Policy 

HIPPA Acknowledgement 

These files are in PDF format.  Adobe Acrobat Reader is availlable to download here.

  

 MD NPP (1).pdf

Testimonials

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