Patient Information

  • Registration Form

    All new patients must fill out these forms (includes registration form, medical history, financial & privacy forms). Your answers to these questions are confidential and for our records only. During your initial visit, we may have questions concerning your health and are happy to discuss our financial policies.

    Download Registration Form

  • Medical History Form

    Your answers to these questions are confidential and for our records only. During your initial visit, we may have questions concerning your health so that we can provide the best oral health care possible.

    Download Medical History Form

  • Financial Policy Form

    We are commited to providing you with the best possible care and we are pleased to discuss our professional fees with you. Your clear understanding of our Financial Policy is important to our professional relationship. Thank you for choosing us as your dental provider.

    Download Financial Policy Form

  • Acknowledgement of Privacy Forms

    This is an acknowledgement that you (our patient) have read and understand the Office of Dr. Sargent and Dr. Markham's privacy practices. This notice describes certain restrictions on the use and disclosure of your protected healthcare information, rights that you may have regarding my protected healthcare information, and how this dental office and the staff may use and disclose my protected healthcare information.

    Download Privacy Forms