Patient Portal

Patient Portal Login

Make A Payment

Please take a minute to fill out the online form. If you would rather print the forms, just print them out the forms and bring them with you to your dental appointment. You may also access our online patient registration by clicking the link below.


** Please note that x-rays will be taken on FIRST appointment unless you bring current x-rays with you or have them emailed to our office.  They can be emailed to info@vipfamilydentistry.com 

Printable Forms

New Patient Health form ( NEW PATIENTS)

FINANCIAL & HIPAA (NEW PATIENTS)

EPWORTH SLEEPINESS (NEW PATIENTS)

INTERNET CONSENT (NEW PATIENTS)

COVID ( ALL PATIENTS, EVERY VISIT)

Medical update (ESTABLISHED PATIENTS ONLY)

Patient Referral


Notice of Privacy Practices HIPAA (this is for your information) 
No Show / Cancelation Policy (this is for your information)
 



 This web site uses files in Adobe Acrobat Portable Document Format  (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.