Patient Forms

We want to welcome you to the Dennis S. O'Leary DDS family!

We welcome new patients to our practice. Every new patient must complete a Patient Information Form, a Financial Policy Agreement, and a HIPAA Acknowledgement. You may print out PDF versions of these forms by clicking the links below and fax them to us at 202-966-8106 or bring them with you to your first visit.

Your first visit will include a review of your medical and dental history. Following that, we will typically take X-Rays and perform a comprehensive examination. This will enable us to determine your needs so that we may work together with you on how to best approach your treatment.

Click below to download New Patient Registration Materials

 

Patient Information Form

Financial Policy

HIPAA Acknowledgement

Oral Health Assessment Form (DC School Form)