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All new patients fill out a Patient Registration Form. I realize that most people hate to fill out these forms. However, this information is very important when  dealing with your insurance company and  providing safe and complete dental care.

For your convenience these forms are available for download from this page. To assure absolute privacy of your information you will complete the forms on your computer in the privacy of your home. The file "registration.exe" is a self extracting zip file. Just double click on the file to extract the registration form. If you are familiar with downloading files click here now. If you need help downloading this file follow the directions below.

Directions for downloading form.

At the end of these instructions you will see the hyperlink
Download form now
click on the link and the following window will appear

Select the "save this program to disk" option 
and then click "OK".

The following window will appear

From this window you select the folder that you want the file saved in. I usually choose the "my documents" folder for downloads. When you click the "save" button the file "registration.exe" will be saved in the "my documents" folder on your computer. 

Just double click on that file and the registration form will be extracted. Open "registration.htm" with your Internet browser working offline so you can fill it out on your computer. Once completed you can print them and bring them on your first appointment. 


Download forms now.


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Copyright© 1998 Walter Bechtell DMD
Last modified: December 28, 2003
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