New Patient Forms


Thank you for selecting our practice to serve your dental needs. We are looking forward to meeting you. Please complete the attached new patient form so that we can be ready and prepared for your arrival. Once completed, please mail to PO Box 1319, Florence, AZ 85132, deliver to 495 N Pinal Prkwy #101 Florence, email to, or fax to 520-868-1200. 


Because we want your dental experience to be the best it can be, please let us know when calling to make your appointment if you will need nitrous sedation or any other special accommodations. Thank you.