Forms

New Patient Forms

Use the tabs below to access our patient enrollment forms. After completing all three forms, press the ‘Submit’ button. Please complete the forms as thoroughly as you can, as the information provided will be used during your initial exam with Dr. Rainey.

These forms will be easiest to complete on a computer (rather than mobile). If you would prefer to print and mail your responses, PDF versions are available (New Patient form, Dental History form, Medical History form). Please contact us if you have any questions.