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C-K Family Dental

New Patient Information


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First, I would like to thank you for considering my practice for you or your family's oral health needs.  Second, please take a moment to review what you can expect at your first appointment in my office:

  • We will fully discuss your Medical and Dental History.

  • You will receive a Complete Head and Neck Evaluation, which will include:

    • recording in your chart all Decayed, Missing, and Filled Teeth;

    • a Full Mouth Series of x-rays, including an orthopantogram (“panorex”);

    • an Oral Cancer Screening, using ViziLite;

    • a Periodontal Screening to evaluate your gum tissue health and bone levels.

  • We will determine the best type of Hygiene appointment for you.

Based on the information gathered above and my evaluation of your x-rays, I will create your personal Treatment Plan.  If time allows we will discuss it, otherwise we will schedule a separate appointment (at no charge).  We will also schedule your Hygiene appointment before you leave.

As you can see, we have a lot to do in a short amount of time.  It's helpful to us if patient's have their forms completed before coming to my office.  Feel free to print the forms below.  Thank you!



Info & Med Hist.
Release Request
Patient Info-HIPAA-Medical History
Release of Records Request
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