Bauer and Howard Dental Care, LLP
Drs. Bauer and Howard
Drs. Bauer and HowardHastings, NE
 
New Patient Forms
 
 

formIf you would like to complete your registration form before you arrive, you may download it by clicking below. The new patient form is in PDF format. If you do not have Acrobat Reader, get a free copy by clicking on the link below. Also, after reading the Notice of Privacy Practices, print the Acknowledgement form below, sign it, and bring it in, too.


Adobe ReaderAdobe PDFMedical History Form (Acrobat PDF form)

Adobe PDFAdult Get Acquainted Questionnaire (Acrobat PDF form)

Adobe PDFChild Get Acquainted Questionnaire (Acrobat PDF form)

Adobe PDFNotice of Privacy Practices (please read this before signing the HIPAA Form) (Acrobat PDF form)

Adobe PDFHIPAA Form (Acrobat PDF form)

Adobe PDFFinancial Policy (Acrobat PDF form)