Patients Forms


We want to welcome you to Arnold Dental Arts!  In order to speed up your intake process we ask that you fill out the forms listed below. If you have records at another dental office and desire to have them transferred, please include the Authorization for Release of Records and send that to the other office directly. You do not have to send back the HIPAA Policy, as this is a document for you to keep! All other forms should be completed, signed, dated, and returned to our office by way of regular mail or electronic mail. For electronic mail return, your forms will be signed at our office when you arrive.

If you have any questions about this process, please contact one of the Administrative Staff members at (636) 296-6885 and they will be happy to assist you.

Patient Forms & Insurance

1. Acquaintance History Forms

2. Insurance Information

Release of Records

3. Authorization for Release of Records

Privacy Policy

4. HIPAA Policy