Please read our Open Letter to our Family of Patients in response to COVID-19.
Read our Open LetterEstablished Patient Yearly Update Form New Patient Paperwork

South Shore Dentistry New Patient Forms


Please follow all of the instructions below to fill out and email your new patient paperwork.

  1. Please fill out the New Patient Paperwork by using the button below. You can fill in the information directly in this PDF and use the “Submit by Email” button at the bottom to send it to us.
    New Patient Paperwork
  2. Please fill out this Acknowledgement of Receipt of the Notice of Privacy Practice (HIPPA). You can fill in the information directly in this PDF and use the “Submit by Email” button at the bottom to send it to us.
    Acknowledgement of Receipt of Notice of Privacy Practice
    Then, use this button to download the Notice of Privacy Practices
    Notice of Privacy Practices
  3. Please fill out the Email and Text Messaging Program Consent Form. You can fill in the information directly in this PDF and use the “Submit by Email” button at the bottom to send it to us.
    Email and Text Messaging Consent Form
  4. Please fill out the Insurance Disclaimer. You can fill in the information directly in this PDF and use the “Submit by Email” button at the bottom to send it to us.
    Insurance Disclaimer