
Third Party Payment Authorization - Download this form if you wish to pay with a credit card for someone else's dental treatment at the Atlanta Dental Group PC.
Monthly Credit Card Agreement - Download this form if you wish to make a monthly credit card prepayment ( lay-a-way ) towards future dental care at the Atlanta Dental Group PC.
Third Party Account/Appointment Authorization - Download this form if you wish to give another person permission to inquire about your Atlanta Dental Group PC account or to make appointments for you.
EZ Pay Dental Patient Agreement - This is a special consent form for patients using EZ Pay Dental.
Patient Registration and Medical History Form - Download this form if you are a new patient with the Atlanta Dental Group PC so that you can fill it out before you come in. Established patients are required to fill out an updated Patient Registration and Medical History form every two years.
Insurance Information Form - Download this form if you have dental insurance and you would like to use your dental insurance as part of your payment for dental treatment at the Atlanta Dental Group PC.
Records transfer to the Atlanta Dental Group PC - Download this form if you are a new patient and want your old dentist to send copies of your old records to the Atlanta Dental Group PC
Records transfer to a new dentist - Download this form if you are a previous patient and you would like the staff at the Atlanta Dental Group PC to send copies of your old dental records to your new dentist.
Cosmetic
Diagnostic Wax Up Approval
Temporary Restorations Approval
Zoom 2 Whitening - This form is required before having the Zoom 2 whitening procedure done at the Atlanta Dental Group PC.
Operative/C&B
Deep Restoration/Elective Root Canal Refusal
Dental Restoration Recementation
Root Canals
Apicoectomy Surgery
TMJ
TMJ Orthopedic Repositioning Appliance
Emergency Soft Guard and Root Canal Therapy
Surgery
Oral Surgery Post Operative Instructions
Dental Implant Placement Surgery
Mini Implant Consent Form
Bone Regeneration/Augmentation Surgery
Dentures
Denture Repair
Sleep Apnea
Dental Organizations
American Academy of Cosmetic Dentistry Release Form
American Academy of Implant Dentistry Release Form