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Patient Forms

Below are electronic version of the medical forms used at Presutti, Derosa and Booth Family Dentistry. We offer these for two major reasons. First, we offer them to improve records accuracy – your responses are typed, instead of hand-written. And second, we offer them to reduce the time spent “in the office.” You will now be able to fill out these forms, and print them from your home computer – at your convenience. This way you won’t have to arrive “15 minutes early” to update your records.

Our forms require the use of the Adobe Acrobat Reader. If you do not have this version, please download it at adobe.com.

Patient Registration for Presutti, Derosa and Booth Family Dentistry
Click here to download Registration PDF
Understanding a patient’s medical and dental history is crucial in providing effective ongoing dental care. This form provides the opportunity to document your medical and dental history.

Presutti, Derosa and Booth Family Dentistry Privacy Practice
Click here to download Privacy PDF
This form outlines the Privacy Practices at Presutti, Derosa and Booth Family Dentistry.  This document outlines your privacy rights, and explains how Presutti, Derosa and Booth Family Dentistry works to protect and secure your dental records.

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We encourage you to contact us whenever you have an interest about our services.