Patient Resources

New Patients

We always welcome new patients here at Third Street Dental, and to make the process even easier you can download our forms to fill out in advance.

Each form can be filled out directly in your PDF Editor, and can be printed to bring along with you for your appointment. Make sure to fill out all of the forms below, and please ensure you fill out the proper forms for your specific dentist.

Alternatively, if you’d prefer, please arrive 10 minutes early to fill out the form in our office prior to your appointment.

IMPORTANT: We request that you bring your printed forms to your appointment, or if you choose to email them, please ensure they are encrypted for security purposes. Should you opt to email the forms unencrypted, you are consenting to the use of an insecure email.

Office Cancellation Policy

Third Street Dental values each and every one of our patients, and we strive to ensure that our office provides high quality dental service. One way we do this is through efficient scheduling. When you book an appointment with us, we reserve a block of time specifically for you and your needs. This means we are reserving time with our Doctor, Assistant and Hygienist, as well as operatory space. We will be sterilizing and preparing the operatory space as well as all the equipment and materials required for your procedure.

We therefore request that if you are unable to attend the scheduled appointment you provide a minimum of two business days’ notice to reschedule or cancel. As a courtesy we will contact you prior to your appointment to remind you of the appointment you have booked. Any short-notice cancellations or missed appointments will result in a short notice or missed appointment fee. Please note that the fee for missed appointments or short notice cancellations is $100 per hour or 30% of professional fees treatment planned.

If a patient shows a pattern of short notice cancellations or no shows, we will ask the patient to find another office that better suits their scheduling needs, and our administrative staff will be happy to transfer the records to their new office of choice. Please note that insurance companies do not cover fees for missed appointments, therefore payment is the responsibility of the patient.