Patient Forms

Patient forms

And, that certainly is the case in health care, especially in the age of COVID-19. Please print out, complete, and sign these forms and consents so we can treat you when you come to our practice.

COVID-19 screening questionnaire

COVID-19 consent

Patient information includes option to provide your preference for text messaging (*see below for more information)

Patient health history

Endodontics office policies

Endodontics consent (wait to sign until you are in the office)

HIPAA consent

HIPAA notice

* SMS opt-in consent or phone numbers collected for SMS purposes will NOT be shared with third parties or affiliates for marketing purposes. We use it for contacting you about your appointments and treatment-related issues. Frequency depends on how often we need to contact you for these purposes. Carriers may charge fees for each message sent or received. These fees can vary based on the carrier's pricing structure and whether the message is sent domestically or internationally. To opt-out later, simply reply with STOP. For assistance, reply HELP. See our HIPAA notice (link above for our privacy policy and terms of service.

About our practice

two dogs laying on floor waiting for patient

Want to know more about Dr. Conner, our office and staff?

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Patient stories

You can read what other patients have to say about their experience with us.

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Patient Stories

Patient stories

"Thanks for taking away the pain and helping me deal with the procedure." Beverly

Online reviews

Read what people are saying about us online. We would love to hear your comments as well.

Facebook Likes

See what our fans say about us on Facebook. We post pictures of our doings on occasion. We'd like you to Like us, too.