For your convenience, we have supplied a printable version of
our New Patient Forms Package. Please complete and ret urn it to us during your next office visit.
Feel free to call us if you have any questions, and we
will assist you.
New Patient Forms Package
The Health Insurance Privacy and Portability Act (HIPAA)
is a federal law designed to protect your personal health information. Willits
& Woltkamp Family and Cosmetic Dentistry is HIPAA compliant. For your
convenience, we have provided a printable version of our HIPAA Notice of Privacy
Practices and Acknowledgement forms. For new patients, please print, sign and
bring the Acknowledgement form to your first visit.
Free Adobe Acrobat
Reader
(necessary for viewing and printing these forms)
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