K Street Dental and Orthodontic Group

Washington DC
3 WASHINGTON CIRCLE, NW SUITE #306
WASHINGTON, DC 20037
(202) 775-0167

GAITHERSBURG
308 MAIN STREET
GAITHERSBURG, MD 20878
(301) 977-9787

Patient Forms

Patient Forms

Please take a minute to print and fill out the patient information form before your first appointment:

» Welcome Form [PDF]
» New Patient Form (English) [PDF]
» New Patient Form (Spanish) [PDF]
» Acknowledgement Receipt of HIPPA Form [PDF]

Additional forms, for your convenience:

» Dental Treatment Consent [PDF]
» Surgical Consent [PDF]
» Endodontic Consent [PDF]
» Post Op Instructions [PDF]
» Credit Pre-Authorization [PDF]

If you're unable to open PDF files, you can get Adobe Reader® for free.

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