Capitol Hill Dental Forms

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

Notice of Privacy Practices

To download the Notice of Privacy Practices, Right Click on the icon below and select "Save Target As", click save, open the document and print the questionnaire. Complete your printed form and bring it to your scheduled 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.

Dental Examination Form

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

Pre-Treatment Estimate & Services Form

To download the Pre-Treatment & Services form, please Right Click on the icon below and select "Save Target As", click save, open the document and print the questionnaire. Complete your printed documents and bring the forms to your scheduled appointment.

Child Registration & History

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