Patient Forms
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For your convenience you may submit your registration to us immediately and securely online |
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Additionally, if you have a change of personal information or medical history, you can update your information here |
Or you may download the forms below, fill them out, and bring them with you to your first appointment. You’ll need to have Adobe Acrobat to use this feature (
click here for the free download.)
Patient Information Form (Download PDF
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Medical History Form (Download PDF)
HIPPA Consent Form (Download PDF)
Authorization for Credit Card Payments (Download PDF)
Release of Records from Another Dental Practice PDF)
We're your Amherst dentist, providing quality dentistry to patients throughout southern NH since 1990.
If you're looking for a Nashua dentist, Merrimack dentist, Hudson dentist, Hollis dentist, Milford dentist, or Brookline dentist, we're conveniently located just around the corner on Route 101A in Amherst, NH.
Amerident Dental Associates Windmere Place, 71 Route 101A Amherst, NH 03031 (603) 262-1299 info@ameridentNH.com
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