Patient Forms

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your oral health needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions at all.

Covid 19 Screening Form (View/Print)

New Patient Forms (Online access to NEW Patient Forms)

Existing Patient Forms (Online access to EXISTING Patient Forms)

Acknowledgement of Receipt of Notice of Privacy Practices (View/Print)

Notice of Privacy Policy Practices (View/Print)

Record Release Form (View/Print)

STOP BANG Questionnaire

Sleep Apnea Health History Questionnaire

Credit Card Authorization


This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

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Hours of Operation

Our Regular Schedule

Omar Mahmassani, D.D.S.

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed