Martinez Dental Solutions Patient Forms
As a new patient to our office, you will need to fill out the forms listed below. They will be provided to you when you arrive for your first appointment, but you may also print them ahead of time and bring the completed forms with you. This will allow us to attend to your dental needs more quickly.
Thank you and please call our office if you have any questions at all.
Patient Health History Form - Child
Patient Health History Form - Adult
Medical Release Form - English
Medical Release Form - Spanish
Notice of Privacy Practices
Office Policies - Spanish
HIPAA - Spanish
Phone Payment Authorization
Photo Release Authorization
Contact Us or call: 904-996-8162