New Patient Forms


 

We are happy to offer our patient forms online. Please feel free to print and fill them out at your convenience before your visit.

 

New Patient Registration

Please download, print and complete this form before your first dental appointment.

Click here to download 

 

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.

Click here to download 

 

HIPAA Form

Please download, print and complete this form before your first dental appointment. This form confirms that you read our Notice of Privacy Practices.

Click here to download 


Medical Update Form

Click here to download 


Financial Policy Form

Click here to download 


If you are unable to view the pdf files, please click on the icon below to download and install Adobe Reader:

Location
Fibonacci Dental Studio
2800 Jackson Boulevard, Suite 9
Rapid City, SD 57702
Phone: 605-578-0038
Office Hours

Get in touch

605-578-0038