New Patient Forms

At Relax Dental, we are dedicated to delivering comfortable, high-tech, and conscientious dental care. We begin with a new patient appointment. During this visit, you’ll meet Dr. Alyateem to discuss your medical and dental health history and goals. We’ll take digital images, x-rays, and conduct a thorough exam. Together, we’ll review the findings, explore treatment options, and develop a treatment plan. Finally, we’ll go over payment options and schedule any necessary follow-up treatments.

Forms Requiring Signature

New Patient Information:

Acknowledgement of Privacy Practices:

Health History:

Office & Financial Policies:

General Information Forms

Notice of Privacy Practices:

PHI Disclosure Form:

Request Appointment

Relax Dental Office