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

Who ever smiles when they say "I have a dental appointment tomorrow"? We do! Dr. Truitt and his staff are kind, cheerful, and professional. It is refreshing to be in a happy dental office that takes care of us routinely and in emergency situations. We live in Lakeland but drive to Winter Haven because it's much better than any other dental office experience.

Amy, from Lakeland