Patient

forms

All of these forms are available at the office upon request. For your convenience, you can download and fill them out before you arrive and hand them to our staff at the front desk.


Registration & Health History Form

Oral Health Risk Factors Questionnaire

Financial Policy Agreement

Patient Consent Form (HIPAA)

Consent of Disclosure Form (HIPAA)

Signature On File (HIPAA)

Amend Patient Records (HIPAA)

To contact Dr. Lisa or to schedule an appointment, call her office at
(610) 559-8001 or click here.

Professional dental care from Dr. Lisa Muff - Medical Dentistry - Easton, PA

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