Patient Forms

Please print and complete these forms at home before your first appointment. If you need assistance with downloading or printing these forms, please contact our office.

Patient History
Supplemental Drug Sheet
Notice of Privacy Practices
Privacy Acknowledgement
Financial Policy

"It’s so cozy and warm and your staff is second to none. I just love them all. My hygienist is a real warm professional. At no time have I ever had pain or discomfort."

"Walking into Dr. Krutchick's office is like stepping into a warm ray of sunshine. From day one, every member of that staff has made me feel comfortable and relaxed in an environment I once feared being in. My dental woes have been resolved one by one."