Patient Forms

Dental Associates of Florida Online New Patient Paperwork

Tampa – New Patient Registration
New Tampa – New Patient Registration
Central Brandon – New Patient Registration
Brooksville – New Patient Registration
Lakeland – New Patient Registration
Plant City – New Patient Registration
Sun City – New Patient Registration
Bartow – New Patient Registration
Winter Haven – New Patient Registration

Dental Associates of Florida Patient Forms

Step 1: Select Form

  • Select form below, and save to your computer
DL Acknowledgement of Receipt of Notice Privacy Practice
DL Consent & Release
DL Letter of Understanding
DL Payment Policy
DL Medical History
DL Patient Registration
DL Oral Cancer Screening

Step 2: Complete Form, either:

  • Print forms and fill out. Bring these to the office for your scheduled appointment.
  • Or, the preferable method, complete the editable PDF on your computer and save the document to upload. See Step 3.

 

Step 3: Submit Form

  • If you choose the preferable method, please submit the forms below. If you choose to print and fill out the form by hand then please bring with you when you come for your appointment. 

 

Dental Associates of Florida Electronic Form Submission

Thank you for taking the time to complete the form online. Please download the PDF and save it to your computer. Once saved, open the form, enter the information and save it to your PC. Once the form is completed, fill in the fields below, attach PDF(s) and submit.

Fill out my online form.