Your Initial Visit – Patient Forms
Your first visit will be a consultation appointment. During this visit, Dr. Clark, Dr. Cole, or Dr. Patel will review your medical history, medications, allergies and your treatment options.
Please bring the following to your consultation appointment:
• Completed Patient Referral Form from your dentist
• All of your insurance information
• A list of your current medications
• A list of your physicians
Unmarried patients under the age of eighteen are considered minors. They must be accompanied by a parent or legal guardian.
- Fill out the appropriate Patient Information form
- Save to your computer
- Scan your Insurance Card, Patient Referral, lists of Medications & Physicians, and save to your computer,
- Email completed form and materials to ccoralsurgery@hotmail.com.
Or bring form with you at your initial appointment.
Adult patient information record
Minor patient information record
Additional Downloadable Forms-
• Postoperative Instruction Sheet
• Privacy Practices and Patients Rights
