William D. Bateman, DMD, LLC

Family, Restorative and Implant Dentistry

Patient Forms

Confidential Information Questionnaire

Print and complete this form to provide us with personal, family and emergency contact information.

Medical and Dental History Form

Print and complete the Medical and Dental History to provide us with information pertaining to your medical history and current medications.

Financial Policy

We offer several payment options for your convenience. This form contains important information regarding our financial policies and payment guidelines.

Receipt of Privacy Practices

Acknowledgement of receipt of Notice of Privacy Practices