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New Patient Forms | Dentist | Henderson, Clark County, NV

We are honored you chose Smile Shop to serve as your dental provider. To help streamline the process of registration, and thus reducing the time you spend in the reception room, please consider downloading and filling out these forms prior to your scheduled appointment. If you are able, you may email them back to us so we may put them in your records so we can review your paperwork beforehand as well.

New Patient Forms (PDF)

Patient Information and Medical History Form

Financial Policy Acknowledgement

Patient Privacy Forms (PDF)

Notice of Privacy Practices (your review only, no signature required)

Privacy Practices Consent and Release Form

 

Specialty Treatment Forms (submitted electronically)

If you are being treated for TMD (temporomandibular joint disorder), sleep apnea, or any oral surgery procedures (extractions, bone grafts, dental implants), please fill out the additional questionnaires and submit them online.

TMJ Evaluation Questionnaire

Oral Surgery / Implant Questionnaire 

Sleep Questionnaire