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Patient Forms
Pratt Family Dental has partnered with Revenue Well so that you can find all patient paperwork online now! Just click the button below and it will take you to our patient connect page, where you can fill out paperwork, make payments, create a patient login in, or even request an appointment!
There is a lot of information that we will need to know in order to best serve you! To help make sure you fill out all the forms we will need, please use the checklist below to help guide you!
Adult Paperwork Checklist:
1. Patient Info
2. Eaglesoft Medical History
3. HIPPA
4. Healthcare Release Form
5. Emergency Contact
6. What brings you to our office?
Pediatric Paperwork Checklist:
1. Pediatric Patient Acquaintance Form
2. Eaglesoft Medical History
3. HIPPA
4. Healthcare Release Form
5. Emergency Contact
6. What brings you to our office?
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