Patient Forms

Once the patient has scheduled their initial appointment at NC Prosthodontic Specialists - Dentures, Implants & Crowns, they can expedite time [...]
Once the patient has scheduled their initial appointment at NC Prosthodontic Specialists – Dentures, Implants & Crowns, they can expedite time in the dental office by clicking on the links below to download the Patient Forms. All forms (including the HIPAA Privacy Conscent Form), must be completed before patients can meet with Drs. Scruggs or Molina for their dental consultation.
- New Patient Welcome Letter
- New Patient Registration
- Patient Medical History Form
- Patient Information Update Form
- Patient Contact Consent Form
- HIPAA Privacy Statement & Consent Form
Please feel free to contact our office if you have any questions or requests at Raleigh Office Phone Number 919-846-6622.