On-line Patient Forms



In line with our philosophy of “Dentistry Beyond Expectations”, our goal is to make every aspect of your patient visit as pleasant as possible at our Southington General and Family Dental Practice. If you prefer to fill out your patient forms in the comfort of your home, we have set up our Patient Medical History and Patient Registration Forms online for your convenience. Please download the following forms and bring the completed information with your insurance card to our office on your first visit:

Download Medical History Form(PDF)

Download Patient Registration Form(PDF)

Get Adobe Reader

Remember – Regular checkups are an important part of maintaining both your overall health and a beautiful smile!

The American Dental Association recommends visiting your dentist every six months for regular checkups and routine teeth cleanings to keep your teeth and gums healthy. We understand that your time is valuable, which is why we schedule only one patient at a time. We look forward to seeing you!

Dental Insurance

Our dental office is both family friendly and insurance friendly! We accept all insurance plans and will work closely with you to help you maximize your benefits. Please be sure to complete the patient forms with all of your current insurance information. On subsequent visits, we will check in with you to ensure we always have your current dental insurance on file. As part of our full-service office – we will file all your claims for you electronically and track payment.

Payment Options

Our first and foremost goal is to ensure that you receive the dental care you need and desire. We understand that your insurance may not cover your entire treatment, or, that you may not have dental insurance. We will work with you to develop a treatment plan and a payment plan that works for you.

In addition to insurance, we accept cash, checks, debit, and most major credit cards. We also offer flexible financing options to help you fit your payments into your monthly budget. Please feel comfortable talking to us about this as we want all our patients to know that we will work with you to decide on not only the best treatment, but also the best payment plan that works for you.