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Patient Forms

If you are a new patient to our office, the attached file contains new patient forms that will need to be filled out when you arrive at our office (Medical History Page 1 and Page 2, Pharmacy Information, and Payment Information). Printing them, filling them out and bringing them with you or scanning and emailing them to rootcanalnyc@gmail.com will allow us to attend to your dental needs more quickly than completing them on your arrival.  The other forms are instructional and can be printed depending on what procedure you have had preformed on your tooth.  Thank you and please call our office if you have any questions at all.

Medical History Form Page 1

Medical History Form Page 2

Pharmacy Information

Payment Arrangements

Pre-Initial Visit Instructions

Post Treatment Instructions Following your first Visit

Post-Endodontic Treatment Instructions

Pre-Treatment Instructions for Endodontic Micro-Surgery

Post-Treatment Instructions for Endodontic Microsurgery

This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.