Patient Forms
The fastest way to make your first visit smooth is to fill out our patient forms before you walk in. Each form is fillable on your phone or computer — no printing required.
We’ve designed our forms to take about 5–10 minutes total. If you’d rather fill them out in the office, that’s fine too — just plan to arrive a few minutes early.
Forms to Complete Before Your First Visit
Patient Registration
Your name, contact information, insurance details, and emergency contact. We use this to set up your file and verify your benefits.
Health History
A full medical history — current medications, allergies, conditions, surgeries, and anything else that might affect your dental care. This information is confidential and used only to inform your treatment plan.
Notice of Privacy Practices (HIPAA)
Your rights as a patient under HIPAA and how we handle your protected health information.
Records Release Form
If you're transferring records from a previous dentist, this is the form to have them sign and return to us.
How to Use These Forms
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Download the PDF to your phone or computer.
- Fill it out — tap or click into each field. The forms are fully fillable; no printing required.
- Save the completed file.
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Bring the file to your appointment on your phone, OR email completed forms to [email protected] ahead of your visit.
If you prefer to print and bring physical forms, that’s fine too. If you have any trouble with the forms or your device, please call (614) 268-5250 and we’ll walk you through it.
Existing Patients Transferring Records
If you were a patient at the Hughes practice at this address, your records are already here. No transfer needed.
If you’re coming from another office, please complete the Records Release Form above and ask your previous dentist to send your records to us. We’re happy to help facilitate this — just call and we’ll handle the paperwork.
Ready to schedule?
Once your forms are complete, you’re ready to book.