Please take a minute to complete our Online Health History Form before your first appointment. The link is found below. When you finish filling out the form, please click the "Submit" button. Your information will be sent directly to us with secure encryption.

Online Health History Form

Request to Release Dental Records

HIPPA Privacy Practices (READ ONLY)

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

 

Please email signed Request to Release Dental Records to:

office@dentistrybymoore.com

 

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