Shown below are some of the forms used by Dr. Howard. In order to view and print these forms, you’ll need the FREE Adobe Reader program. If you don’t have Adobe Reader, click the icon below and follow the instructions to download it, then install it.

New Patient form (two pages) - If you are a new patient who has not previously visited one of our offices, we request that you print these two pages, fill in your information, and bring them with you on your first visit.

Click on each form below to view in Adobe Reader, then print each form.
New Patient form - page 1 New Patient form - page 2

Rate Your Smile - Tell us what you like/dislike about your smile. Print the form, answer all the questions, and bring it with you on your next visit to one of our offices.

Click on this form to view in Adobe reader, then print the form.
Tell Us About Your Smile form

Click on each form to view in Adobe Reader, then print each form.

HIPAA - Privacy practices regarding disclosure of your health information. Please feel free to print these forms for your personal reference.
HIPAA form - page 1 HIPAA form - page 2

Insurance Questions/Answers - Helpful information regarding your dental insurance and your acceptance of all unpaid balances.  Print, sign, and return on your next visit.
Insurance Q/A

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