Patient Forms

Online Patient Forms

For New Patients

If you are a new patient and haven't scheduled an appointment, please use the online tool to request an appointment, or otherwise you can also call the office to set up your first appointment.

Once your appointment is set we will send you a text message with a link to your new patient forms. Or, after you are in our system, you can use the link to the Patient Portal below to reach your forms.

For Existing Patients

The link below will access the online patient portal where you can fill out new or updated patient forms:

Rand Dental Associates: Patient Portal

Other Printable Forms

If you would prefer, you may print your registration forms to fill out ahead of your visit, rather than filling them out online.

  • New Adult Patient Form
  • New Pediatric Patient Form
  • Consent to Share Confidential Medical Information

If the patient is a minor and must be accompanied to the office by someone who is not a parent or guardian, then please fill out and provide us with the following form to document your consent.

  • Authorization For a Designated Adult to
    Consent For and Accompany a Minor Patient
    (PDF File is in English y en español)

The following forms are informative and do not need to be signed or presented in office. Rather, they are provided here so that you may download a copy for your records.

If you are unable to open and view PDF files, you can download Adobe Reader® for free to view them.