Important Dental Office Forms

Dental patients can fill out the necessary forms and research answers prior to visiting the office.

Dr. Violette offers the following office forms for downloading and printing:

New Dental Patients

Patient Information Form
Our patient info form is used to collect general information about each patient for our files

Medical-Dental Profile
This form is used to establish a dental patient's medical history

Patient Office Policies
Used to inform the patient of the various financial & cancellation policies of David P. Violette, D.D.S., P.C.

Existing Dental Patients / Miscellaneous

Caries Risk Assessment & Treatment Options
Form used for classifying re-care patients

Employee Application
Application for prospective employees of David Violette, D.D.S.

Financial Arrangements
Used to establish the patient's payment arrangements

General Consent Form
Form used to verify a patient's consent for certain procedures

Notification Of Periodontal Disease
Used to discuss treatment options with patients having periodontal disease

Patient Satisfaction Survey
Patients can use this form to provide feedback on their experience in our office (online feedback form available here)

Three Month Re-Care
Form used to schedule a visit three months after initial periodontal disease treatment

Xylitol Information
Learn about the benefits of xylitol – reducing acidity in the mouth, pH balance restoration, and remineralization of tooth enamel

Having trouble viewing the above forms? Download Adobe Acrobat Reader here.