Please contact us to schedule an appointment. Once you have a scheduled appointment you may download the following forms and fill them out at your convience. You can either bring the completed forms to your Initial appointment or fax it to (623)536-7385. We understand that the information you are sending is private and can assure you that it will be handled accordingly. Please do not hesitate to contact us if any questions or issues arise while completing the forms. We look forward to meeting you!
Read NOTICES OF PRIVACY PRACTICES
NEW PATIENT REGISTRATION FORM
COVID 19 MEDICAL QUESTIONNAIRE
UPDATE FORM - MEDICAL HISTORY AND INSURANCE
CONSENT FOR EMAIL/TEXT COMMUNICATION
CHILD RELEASE / TREATMENT FORM
All forms are in Adobe PDF format. You may download the latest version of Adobe Reader here.
"I love this place! It has the feel of a small town dentist. Everyone is very friendly and personable."
Dr. Jay and his staff are always helpful and friendly. I really like the fact they always take their time and I never feel rushed. I highly recommend Dr. Jay and his staff.
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