Below you will find the forms you will need for your first visit with us. To print these forms just click on each link below. The file will download. Just click on print and fill out the form and bring it with you on your first visit.
Adult new patients will need: Child new patients will need:
1. NP ADULT FORM.pdf 1. NP CHILD FORM.pdf
2. Dental History 12 1 2009.pdf 2. Dental History 12 1 2009.pdf
3. Payment Policy 3. Payment Policy
4. NOTICE OF PRIVACY PRACTICES2. 4. NOTICE OF PRIVACY PRACTICES2.pdf
4a. HIPAA Authorization 2016.pdf 4a . NOTICE OF PRIVACY PRACTICES2.pdf
5. Notice of Privacy 12 1 2009.pmd.pdf 5. Notice of Privacy 12 1 2009.pmd.pdf
6. Email and cell phone reminder card.pdf 6. Email and cell phone reminder card.pdf
7. Medical History.pdf 7. Medical History.pdf
I wouldn't go to any other dentist. I've been coming here for over 30 years and can't never say enough good things about BV Dental Association. Thank you
Jeanne D. 11/1/17
Dr. Galanis is a wonderful dentist! I am very nervous about going to the dentist and he always makes me feel comfortable. I have now had 3 root canals done and he was so gentle during the procedures. He goes out of his way to make sure that I understand what is going on and to make sure that I'm ok.