Thank you for completing these forms before your visit. This will allow our staff to perform the most complete evaluation possible when you arrive for your appointment. Dr. Verigin makes a point of studying these records thoroughly before your first visit, so the more detail you provide, the more productive your upcoming visit can be.

Please fill out ALL of the new patient forms. Enter your information into the form, and at the end, press “SUBMIT. The system will securely send us the form. The forms go DIRECTLY to our office and will not be seen by anyone else.

If the form was submitted successfully, you will be directed to the next form.

Thank you, again, for your confidence in our dental care. We look forward to seeing you!

Gary M. Verigin, DDS