Savannah Dentistry Information – Dental Patient Forms – Mark Dye, D.M.D.

If you are a new patient to our office, the attached file contains our new patient bundle with forms that will need to be filled out when you arrive at our office.  Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please contact us if you have any questions at all.

Patient Forms
New Patient Health Form

HIPPA Privacy Statement

HIPPA Consent Form

Office Policies and Financial Information

Authorization of Record Release Form

 

Privacy and Security Statement

Mark N. Dye, DMD, LLC is committed to protecting your privacy and has created this statement to outline our approach in this regard. The following discloses the information gathering and dissemination practices for our web sites. If you have any concerns, comments or complaints, please let us know.

Privacy and Security Statement

 

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Mark N Dye, DMD LLC

Cosmetic & General Dentistry

310 Eisenhower Drive

Building 14

Savannah, GA  31406