Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data are one of our primary concerns and we have taken every precaution to protect it. To schedule same-day Sevices a $150 deposit is required. All deposits are applied to scheduled surgical treatment and/ or surgical services and are non-refundable. If the appointment is canceled within 48 hours (2 days) of the scheduled appointment. No exceptions unless proof of a major mishap.

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Online oral surgery patient registration

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