× Attention Patients: Dental Appointments & New Procedures

Forms

Patient Medical Record

New Patient Paperwork - Rother Dental
click to open/download PDF

Patient Record Access Form

Patient Records Access Form
click to open/download PDF

We look forward to meeting you!

New patient paperwork is very important for us at Rother Dental to understand your preferences and background so we can make your experience here a great one.

Please click the PDF button to the left to download and print our new patient paperwork pdf to bring along with you to your first visit at our office.

Privacy Policy

Let us know how else we can help!

Whether you are moving out of the area, need your records for a specialist office or any other reason, please print/fill out this form and return to our office to receive your fill records from our practice.