Royal Lakes Family Dental
A Great Dentist

New Patient Forms

New Patient Paperwork

For your initial visit, please take a moment to print out and complete the Patient Registration, Medical History, HIPAA Privacy Notice and I the Insurance and Financial policy.  Please bring it with you to your appointment or you can print it, scan it, and send it via email to [email protected] and we will have it on file and ready for you visit.

Medical History

New Patient Registration

Insurance and Financial Policy

HIPAA Acknowledgement

RLFD Dental Benefit Membership

Have Questions? Get in Touch
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View the ADA Accessibility Statement