East Avenue Dentistry PLLC
Great Experience. Great Smile!

Patient Forms

If you are a new patient to our office, below contains our new patient forms that will need to be filled out before you arrive at our office. Filling them out will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all.

Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.

Click Here For Online Patient Forms


Adult Patient Forms

  1. New Patient Registration (required)
  2. Adult Medical History Form (required)
  3. Notice of Privacy Practice (please read, print only if you want a physical copy)
  4. Acknowledgment of Receipt of Notice of Privacy Practices (required)


Child Patient Forms

  1. New Patient Registration (required)
  2. Child Medical History Form (required)
  3. Notice of Privacy Practice (please read, print only if you want a physical copy)
  4. Acknowledgement of Receipt of Notice of Privacy Practices (required)

Testimonials

I went to East Ave Dentistry for the first time recently, and it was such an amazing experience. As soon as you walk in, the staff is so nice and welcoming! They knew it was my first time there before I even checked in, and introduced themselves and had such positive attitudes. My hygienist was Kari Caves and she was incredible. She was so thorough and made sure I was comfortable throughout the entire experience. I also spoke with two different dentists about some concerns I had and they gave me thoughtful opinions and advice. They also have massaging chairs and TVs right in front of you! Overall the best experience I’ve ever had at a dentist office and I don’t think I will ever be going anywhere else!

Amanda C.

"All the doctors give you their full attention when discussing your treatment plan. Their eye contact makes me feel like I have their complete attention."

Rachel C.

View More