Downloadable Patient Forms

At Ackerman Family Dental we know your time is valuable.  To expedite assisting your needs, the following forms are available for printing and filling-out prior to your first visit.  To save you time, bring the completed forms so we can immediately review them and assist you.


Access to the forms below requires Adobe Acrobat Reader.

Health History

Our health history form and patient registration form should be completed prior to treatment.
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Financial Policy

We strive to offer the best dental care for our patients. Please see our financial and insurance policy for details.
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Cancellation Policy

While cancellations are sometimes out of our patients’ control, out of respect to all of our patients, we ask that you review our cancellation policy.
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HIPAA and Privacy

We strictly follow all privacy guidelines. Please complete our HIPAA form prior to treatment.
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