We ask that all new patients complete the form below, please download the form and complete
it prior to arriving for your first appointment. If you prefer, you're welcome to fax the completed
form to (718)624-1582.
If you have any questions please call us at (718)625-2116, a member of our staff
would be happy to assist you. We look forward to meeting you and we thank you for entrusting us with
your dental health.