New  Patient  Forms

Our New Patient Forms are now interactive!
    Our new forms can be filled out in many convenient ways.
          Open the form online, type in your information, print filled-out forms, then bring to initial appointment!
            Open the form online, type in your information, save to a data file, and attach in an email to: ache_director@yahoo.com
            Download any one form individually, or all forms at once in a .rar / .zip file; fill them out on paper, and bring.

To open forms online, and either print or email, click each form below, and either fill out and email or save to your computer and print.
            All forms require Adobe Reader to open or use.  Download Adobe Reader 9 for free>>

•   Dental History Form

•   Dental Treatment Consent Form

•   Notice of Privacy Practices Acknowledgement Form

•   Patient Record of Disclosures Form

•   Patient Registration and Medical History Form

To download all forms at once, and save to your computer, click below.

•   New Patient Forms Packet (ALL)

Forms must be filled out completely.  All forms are necessary for all new patients.  We ask existing patients to update their information and fill out new forms every six (6) months.  If you are emailing your forms, you will need to show ID and sign all forms at your initial visit before seeing the dentist.  Thank you!

Send mail to webmaster@ache-clinic.com with questions or comments about this web site.
Copyright © 2009 Alvin Community Health Endeavor