Online Forms

Dr. Harrision has provided our office forms for our patients to fill out at their convenience. Don't forget to bring the completed form(s) with you to your appointment.

Forms to be completed by new adult patients: Administrative Policies, Adult Health History, HIPPA Consent Form, Patient Registration.

Forms to be completed by parent or guardian of new child patients under 13 years of age: Administrative Policies, Child Health History, HIPPA Consent Form, Patient Registration.

• Administrative Policies
• Child Health History
• Adult Health History
• HIPAA Privacy Policy
• HIPPA Consent Form
• Patient Registration
• Root Canal Therapy Consent
• Surgical Informed Consent

Our online forms use Adobe Acrobat Reader. Please download the free plugin from Adobe's web site if it is not already installed on your system.