Patient Forms

Patient Registration Forms

We thank you for your trust in our office. Please download, print, and fill out the patient information sheet or medical history form and bring them on your first visit, so that we may assist you more efficiently and deliver quality care. We ensure every precaution is taken to protect your sensitive personal data. Click on the following links below to download the patient registration forms.

Technical Note: To view our form, you need to download the latest version of Adobe Acrobat Reader from Adobe’s web site.  https://get.adobe.com/reader/?trackingid=KQGEP

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Dr. Changela is an excellent dentist. He explained very detail before any treatments. I have a lot of dental work done. He will not do unnecessary work just to get pay. The office is very clean, the wait time is very minimal. My husband and I have seen Dr. Changela for over 4 years, and we are very happy with him.

Tina Nordin