We are happy to offer our forms and applications for download. Please feel free to print these and fill them out at your convenience before your visit. Please do not email these forms over the Internet.
Health History (2 pages)This form needs to be filled out before your first dental appointment.
Click here to download (792KB)
HIPAA FormThis form acknowledges that you have read the "Notice of Privacy Practices" below.
Click here to download (341KB)
Notice of Privacy PracticesThis document is for your general information as required by federal HIPAA laws.
Click here to download (1.3MB)
If you are unable to view the pdf files, please click on the icon below to download and install Adobe Reader:
Laurie Deemer, DMD
2104 Newton Drive, NE
Covington, GA 30014
Phone: (770) 787-2828
Fax: (770) 786-2167