New patient forms

Welcome, and thank you for choosing Sparta Smiles Synergy for your comprehensive dental care! We look forward to working as a team to keep you smiling. As a new patient, you will be responsible for completing the forms below. Please complete the forms to the best of your ability, scan and return them to our office, or complete them digitally at least 24 hours before your first visit.

Health History Form (download/print) | Digital form

COVID-19 Screening Form (download/print) | Digital form

HIPAA Compliance Form (download/print) | Digital form

Insurance Verification Form (download/print) | Digital form

Financial Policy & Agreement Form (download/print) | Digital form

Current patient forms

Are you planning to see us soon for your next dental check-up? Before your visit, please find the routine update forms below.

Please complete, scan, and return them to us via e-mail at spartasynergy155@gmail.com or submit them digitally at least 24 hours before your appointment. Thank you for your continued trust in us. We look forward to seeing you and your smile again soon!

Medical Update Form (download/print) | Digital form

COVID-19 Screening Form (download/print) | Digital form