To Our Dear New Patient

Thank you for choosing Bucks Dental Health and Esthetics, the group that specializes in Prosthodontics, Cosmetic, Endodontics, and Implant Dentistry.

You can find our new patient online registration forms (Registration, medical, HIPPA, etc.) by clicking the link below. You can fill them up directly online and will be received by our office electronically once you submit it. If you have difficulty filling it online, you can also print it out, fill it up, and bring it to our office.

You will need to fill one set of forms for each member of your family who will come to our office. Once you submit one, use the same web form link again to fill for the next family member.

Please kindly note that:

• For us to provide you the best dental care with your comprehensive medical and dental history in mind, and for us to timely and accurately process your insurance claim, please make sure that you fill all the information COMPLETELY AND ACCURATELY. Your information is secured in our medical HIPAA-compliant server.
• When you come in for your first visit, please present your state photo ID, SSN, and your dental insurance card to help us process your insurance reimbursement.
• There are about five forms listed on the left column, which you will see. Once you finish one, click the second form on the left column. Once you complete and sign them all, you can then submit them.