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

Dr. Truitt has been our dentist for many years and my husband and I have complete confidence in his care. Whenever we have had emergencies, he has taken care of our needs immediately. In addition to being a wonderful dentist, he has a great "chairside manner"-- always kind and reassuring. He and everone on his staff are very pleasant and make us feel comfortable and at ease when we are there.

Jesslyn, from Lake Wales