Patient Forms

Consultation Room

Patient Registration


New patients may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Patient Registration

If you are a new patient please complete the online registration forms above. We ask for all patients to arrive 15 minutes prior to your appointment.


HIPAA Privacy Form


Please click on the link below to download our HIPAA Privacy form. Please print and complete the forms prior to your appointment. Please be sure to bring the completed form to your appointment, along with your insurance card. If you are unable to print the forms, please plan to arrive early for your appointment so that you can complete it in our office.

HIPAA Privacy Form

Medical Clearance Form


Please click on the link below to download our Medical Clearance form. If one of our oral surgeons requests that you obtain a Medical Clearance, then the completed Medical Clearance form is needed FROM YOUR PHYSICIAN BEFORE your DATE OF SURGERY. Please print the form and have your physician complete the forms and then fax them back to our office. All the necessary information is located on the form. If you are unable to print the form, please direct your physician to our website at paramountoralsurgery.com and click on Surgical Forms.

Medical Clearance Form