Forms

We want your visit to be smooth and pleasant, so we took our most common forms that patients like you have filled out, and gathered them here. If you fill out the forms on this page and bring them to your appointment, we'll be that much closer to having you on your way with a great smile!

Please click the form name(s) below to download and prefill the forms.

A patient fills out a form ahead of time

Patient Registration

Patient Acknowledgement of Receipt of Notice of Privacy Practices

Health History

Medical Update

Treatment Authorization for Minors

HIPAA Notice of Privacy Practices

Your neighbor says

My experience with Dr. Truitt and his staff has always been positive since I began seeing him years ago. He is very skilled and competent and his office is state of the art. All of the people who are part of the staff, from receptionist to hygienist, are professional, competent and friendly. I would give them all an extremely high efficiency rating!

Susan, from Lakeland