For your convenience, we have provided our patient intake forms for download. To lessen the time of your visit, simply download the following 2 forms and fill them out before you arrive.

In order to view and print the forms you will need the free Adobe Acrobat Reader available from Adobe here.

Instructions:

  1. Download the forms.
  2. Open them with Adobe Acrobat Reader (most computers have it installed already)
  3. Optional: Fill the forms out in Adobe Acrobat Reader.
  4. Print and bring in for your first visit.

    Health History Form
    New Patient Information Form

 

 

 

 


L. Wayne Bossola, D.M.D.
Practice Limited to Periodontics and Dental Implants
Butler Office: (724) 282-0616  • Natrona Heights Office: (724) 224-3083