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Below you will find a list of forms that you may click and download. All of the forms with TITLES IN RED are required to be completed before you see the doctor. Feel free to call our office at (973) 383-8080 if you have any questions regarding them. PATIENT REGISTRATION FORM This form may be filled out and submitted online or downloaded and printed for your convenience. To save time, many patients prefer to print this form out, fill it out at home, and bring it to their appointment already completed. - Click here to fill out the Patient Registration form and submit it online -
- Click here to download a printable PDF version of the Patient Registration Form - LAKESIDE ENDODONTICS - PAYMENT ARRANGEMENTS
This form may be downloaded and printed for your convenience. To save time, many patients prefer to print this form out, fill it out at home, and bring it to their appointment already completed. This form MUST be completed before services are rendered. - Click here to download a printable PDF version of the Payment Arrangement Form -
LAKESIDE ENDODONTICS - PATIENT CONSENT FORM This form may be downloaded and printed for your convenience. To save time, many
patients prefer to print this form out and sign it ahead of time. This form MUST be completed before services are rendered. - Click here to download a printable PDF version of the Patient Consent Form - LAKESIDE ENDODONTICS - Notice of Patient Privacy Act
This form may be downloaded and printed for your convenience. To save time, many patients prefer to print this form out and sign it ahead of time. This form MUST be completed before services are rendered. LAKESIDE ENDODONTICS - Doctor's Referral Form This form may be filled out by a referring dentist in the interest of saving both our office and his patients time. It can also be completed online or downloaded and printed. - Click here to fill out the Doctor's Referral Form and submit it online - - Click here to download a printable PDF version of the Doctor's Referral Form - LAKESIDE ENDODONTICS - POST-TREATMENT INSTRUCTIONS Our office wishes to inform our patients of what to expect following root canal treatment. Below you will find 2 versions of post-treatment forms. The "After Your First Visit" form explains what to expect following your initial treatment visit and the "After Treatment" form explains what to expect after treatment is complete. |