Forms

Patient Forms

MacArthur Park Dentistry provides the forms below to make your first visit more convenient for you. For faster service, please print and fill out all the forms beforehand and bring them with you when you come in for your appointment.

  • New Patient Registration Form. This form is for new patients who are scheduling their first visit with MacArthur Park Dentistry. You can download and fill out the form prior to your visit.
  • Office Policy. This form provides information that includes our payment policy, your payment options, insurance claims, and missed appointments. Video: Insurance Information.
  • HIPPA Notice of Privacy Practices. This notice informs you about your rights to privacy regarding your protected health information, and how this information may be used.
  • HIPPA Privacy Practices Acknowledgement Form. Patients are to download and complete this HIPPA Acknowledgement form prior to their visit to our office.
Email:
office@macarthurparkdentistry.com
Phone:
972-831-9600