Form Downloads in PDF format

information from the  Atlanta Dental Group PC

side effects of root canal

Financial Forms

          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 Forms

          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 Forms

          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.

Consent Forms

Cosmetic

          Cosmetic Consultation

          Diagnostic Wax Up Approval

          Temporary Restorations Approval

          Final Restorations Approval

          Zoom 2 Whitening - This form is required before having the Zoom 2 whitening procedure done at the Atlanta Dental Group PC.

          Tooth Whitening Instructions

Operative/C&B

          Deep Restoration/Elective Root Canal Refusal

          Post and Core

          Dental Restoration Recementation

Root Canals

          Root Canal Treatment

          Apicoectomy Surgery

TMJ

          Soft Guard

          TMD/TMJ Soft Guard Treatment

          TMJ Orthopedic Repositioning Appliance

          Emergency Soft Guard and Root Canal Therapy

Surgery

          Serious Dental Infection

          Oral Surgery

          Oral Surgery Post Operative Instructions

          Gingival Graft

          Periodontal Surgery

          Scaling and Root Planing

          Frenectomy

          Extraction Socket Grafting

          Dental Implant Placement Surgery

          Mini Implant Consent Form

          Sinus Augmentation Surgery

          Bone Regeneration/Augmentation Surgery

          Bone Expansion

Dentures

          Temporary Dentures

          Denture

  Final Denture Set Up Approval

  Denture Repair

Sleep Apnea

          Sleep Apnea

Dental Organizations

          American Academy of Cosmetic Dentistry Release Form

          American Academy of Implant Dentistry Release Form

 

Atlanta Dental Group PC employee/company forms

More dental information from the Atlanta Dental Group PC

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