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Don't Forget to Download, Print and Bring the Appropriate Form to Your Appointment!!



Adult Health Questionnaire

To download the Adult Health Questionnaire, please Right Click on the icon below and select "Save Target As", click save, open the document and print the questionnaire. Complete your printed questionnaire and bring the form to your scheduled appointment.

Download Patient_Registration_-_Capitol_Hill_Dental_Associates.doc

Child Registration & History

To download the Child's Registration And History Form, please Right Click on the icon below and select "Save Target As", click save, open the document and print the questionnaire. Complete the Child's Registration printed form and bring it to your scheduled appointment.       

 

Download Child'sReg.pdf

Responsibility and Consent Statement

To download the Responsiblity and Consent Form, please Right Click on the icon below and select "Save Target As", click save, open the document and print the form. Complete the Responsibility and Consent printed form and bring it to your scheduled appointment.

Download Consent.pdf


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