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Patient Forms

New Patient Form

If you’re a new patient, please print out this form, fill it out and bring it with you when you come for your appointment.

Crown Care Form

If you have received a permanent crown, this form will give you instructions on how to care for it. 

Temporary Crown Care

If you have received a temporary crown, this form will give you instructions on how to care for it.

Extraction Post Op Form

If you have received a permanent crown, this form will give you instructions on how to care for it.

Extraction Consent Form

Fill this form out if you’re having any extractions or oral surgery.

Invisalign Consent Form

If you are getting Invisalign, please fill out this form and bring it in the day of your first visit.

Orthodontic Final Phase Retainer Care

If you have received retainers, this form will give you instructions on how to care for them.

Dr. Pike's Patient Forms

Implant Care Form

If you’ve had an implant, this form will give you instructions on how you can take care of it.

Implant Consent Form

This is the form you fill out if you’re having an implant done.

Implant Post Op

If you’ve had an implant done, this is the form that tells you how to take care of it just after the procedure.

Implant Sequence

This form explains the 2 step process of the dental implant and other information you need to know.

Post Surgical Instructions

If you’ve had surgery, this form will help you with the post operative care you should know about.

Dr. Bui Patient Forms

Post Op Apical Surgery Form

This is the form that has the post-op instructions after apical surgery. Print this out and follow the instructions for the best recovery.

Informed Consent Endontic

Fill this out and bring it with you on the day of your apical surgery. It goes over the treatment plan and costs.

Post-Op Root Canal

This is the form that goes over the post-op care instructions after you’ve had a root canal.

Internal Bleaching Consent

Fill this form out and bring it in on the day of your appointment.  

Endodontic Consent Form

If you’re having a root canal, please fill this out and bring it in prior to your root canal appointment.