Administrative OfficeIvor Dental CenterIvor Medical CenterSurry Medical CenterWaverly Medical CenterAll Locations
Smaller A Normal A Larger A
Forms & Policies Cover
For Patients
Forms & Policies

Please use this page to conveniently download our Forms and review our Policies.

Forms

New Patient Registration (Adult)  - This registration packet must be completed before your first visit with any Horizon Health Services provider. 

New Patient Registration (Child 0-18) - This registration packet must be completed before your first visit with any Horizon Health Services provider. 

Dental Health History Form - This form is to be completed before your first visit with our dentist or dental hygienist. It will also be updated annually. 

Sliding Fee Discount Program Application - This application must be completed and returned for consideration for the Sliding Fee Discount Program.

 

Policies

 Patient Privacy Information

 No Show Policy

Notice of Privacy Practices

Patient Rights and Responsibilities

 

Home » For Patients » Forms & Policies
Share