Patient forms

Prepare for your visit

To make your experience as efficient as possible, you may find electronic versions of Samfar Family Dentistry’s patient registration forms below. Once downloaded and completed, you have the option of either sending these forms directly to our center, or simply printing and bringing the forms with you on the day of your service.

01

PATIENT FORMS

02

WARRANTY PLEDGE

PLEASE KNOW

These forms may NOT be submitted electronically, but rather emailed or printed as instructed.
You may also need to download Adobe Acrobat to view, complete, and save/print your forms.