Patient Forms


 

We look forward to seeing you at your first appointment.  For your convenience and to save time at your initial visit, please download and complete the forms below.

If you have dental insurance,  please provide your benefits information to our team prior to your first visit.  This will enable us to perform a complimentary benefits check prior to your arrival so we can accurately estimate any co-pays and deductibles.

Finally, if you have any questions about your appointment, we are happy to help. Please call (212)534-3020


Patient Medical History

Records Release Form

Credit Card Authorization Form

Location
Bar and Smith Dental
1737 York Avenue, Suite 1A
Upper East Side

New York, NY 10128
Phone: 212-235-7173
Fax: 212-534-4071
Office Hours

Get in touch

212-235-7173