Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

  • New Patient Information and Health History PDF
  • Privacy Policy PDF
  • Acknowledgement of Privacy Policy and Authorization to Disclose PDF
  • Financial Agreement PDF
  • Records Release (for other provider to send records to O'Keefe, DMD) PDF
  • Records Release (for O'Keefe, DMD to send records to another provider) PDF

If you're unable to open PDF files, you can get Adobe Reader® for free.

Back to Top