Dr. Chris Anderson is a Pankey© Institute trained Dentist.

New Patient Forms:

Please print, complete and sign each of the forms below.  Bring the completed forms with you to your first visit.   If you cannot complete these forms ahead of time, please arrive 15 minutes early for your first appointment (we can provide you a copy of the forms when you arrive).  Also, remember to bring a valid picture ID (drivers license, etc) and a copy of your insurance card.  Remember to check the information on the Payment Options page to make sure your insurance will work at our office.

Please remember that appointment times are reserved especially for you, so if you are unable to keep your appointment, please call the office at least 24 hours in advance so that we may offer that time slot to another patient.

If you are in discomfort and call us during regular office hours, we will make every attempt to see you that same day.   Please call early in the day so that we may accommodate you as soon as possible.

Here are the new patient forms that you can complete ahead of your first visit:     (Come 15 minutes early if you wish to complete these forms at our office.)

New Patient Information Form

New Patient Medical and Dental History Form

Authorization to release recent X-Rays TO Christopher M. Anderson, DMD     If your previous dentist has recent x-rays, that may save you some unnecessary expense by sharing them with our office.
    Use this form to request those recent x-rays FROM your previous dentist, etc., to be sent TO our office.

    ***Note that your previous dentist, etc., may perfer/require you to use their own release form.

Our Notice of Privacy Practices (NPP) (This is your's to keep.)

Acknowledgement of Receipt of Notice of Privacy Practices (This form needs to be signed.)

Existing Patient Forms:

Please print, complete and sign each of the forms below as necessary.  Bring the completed forms with you to your next visit.

Here are the forms for current patients:

Patient Information Update Form

Patient Medical and Dental History Update Form

Authorization to Release Confidential Information Form     You can use this form to request your records be sent to a specialist, etc.

Our Notice of Privacy Practices (NPP) (updated 0-11-2015) (This is your's to keep.)

Acknowledgement of Receipt of Notice of Privacy Practices (This form needs to be signed.)