---
title: "Forms"
url: "https://montecitodental-lasvegas.com/forms/"
post_type: "page"
date_published: "2015-11-19T02:42:38-08:00"
date_modified: "2024-10-30T19:08:45-07:00"
---

# Forms

Smile Checklist
Review our checklist to help us learn more about your smile.
				Click here for the Smile Checklist
			
			
				
				
				
				
			
				
				
				
				
				
				
				
				
				
				
				
			
			
				
				
				
				
				
				
				
				
				
				New Patient FormTell us about yourself. We’d like to know about your previous medical history and past treatments.
				Click here for the Patient Health History Form
			
			
				
				
				
				
			
				
				
				
				
				
				
				
				
				
				
				
			
			
				
				
				
				
				
				
				
				
				
				Hippa Sign Off Form
Your privacy is our #1 priority. Review and sign this form before coming in.
				Click here for the HIPPA Form
			
			
				
				
				
				
			
				
				
				
				
				
				
				
				
				
				
				
			
			
				
				
				
				
				
				
				
				
				
				Insurance Policy Consent
We’d like to learn more about your insurance plan and make sure that we have permission to submit on your behalf.
Read our tidbits about your insurance here.
				Click here for the Insurance Policy & Consent
			
			
				
				
				
				
			
				
				
				
				
				
				
				
				
				
				
				
			
			
				
				
				
				
				
				
				
				
				
				Office Financial Policy
Review our financial office policies when receiving treatment.
				Click here for the Office Financial Policy
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