Patient Forms
To make your visit as easy and efficient as possible, we have organized our patient forms into two simple sections. New patients can complete the forms needed before their first appointment, while existing patients can quickly update their information before a return visit.
Completing forms in advance helps us prepare for your appointment, verify important details, and spend more of your visit focused on your dental care.
New Patient Forms
Welcome to the practice of Marielaina Perrone, DDS. We look forward to meeting you and learning more about your dental health, concerns, and goals.
Please complete the following forms before your first appointment:
- New Patient Information Form
- Dental and Health History Form
- Notice of Privacy Practices Acknowledgement
- Dental Insurance Coverage Form
- Financial Policy Agreement
Please review each form carefully and provide complete, accurate information. Your medical history, medications, allergies, dental concerns, and insurance details help us create a safer and more personalized treatment experience.
Existing Patient Updates
Your health, medications, insurance coverage, address, and contact information can change over time. Keeping your records current allows us to provide safe, accurate, and efficient care at every visit.
Existing patients may use the update forms to report changes to:
- Contact information
- Address or phone number
- Dental insurance coverage
- Medical conditions
- Current medications
- Allergies
- Recent surgeries or hospitalizations
- Emergency contact information
- Dental concerns since the last visit
Even when there have been no major changes, we may periodically ask you to review and confirm your information.
Before Your Appointment
Please complete your forms before your scheduled visit whenever possible and bring to your appointment. If you are unable to complete them in advance, arrive a few minutes early and we will be happy to assist you.
For questions about patient forms or your upcoming appointment, call our Henderson dental office at (702) 458-2929.
Your Health. Your Comfort. Your Smile.
At the practice of Marielaina Perrone, DDS, every detail of your experience matters. Accurate patient information helps us better understand your needs, protect your health, and provide the personalized care you deserve.
We look forward to welcoming you to our office in Henderson, Nevada.