Healthy Smiles Dental Care | Patient Forms in Mason

Healthy Smiles Dental Care

668 Reading Road
Mason OH 45040

513-339-1032

A Path to A Beautiful Smile and Wellness

Patient Forms
 

New Patient Registration

Please download, print and complete this form before your first dental appointment.

Click here to download

 

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.

Click here to download

 

HIPAA Form

Please download, print and complete this form before your first dental appointment. This form confirms that you read our Notice of Privacy Practices.

Click here to download

 

 
 
 
Mason Dentist | Patient Forms. Sulbha Midha is a Mason Dentist.