William D. Titus DMD, PL
COSMETIC & GENERAL DENTISTRY

PHONE:  (904) 879-3786 

Home
Dr. Titus, DMD
Minor Patients
Saving Teeth
Special Offer
Location
Rampant Decay
ZOOM Whitening
Premium Services
Gum Disease
PerioProtect
Sonicare
Crown Lengthening
Amalgam vs. Composite
Why a crown?
Need a Root Canal?
Extraction Considerations
Post-extraction Care
Dental Emergencies
Immed./Conv. Dentures
Caring for Dentures
Financing
Referrals
The Dental Club
Dental Pulp Stem Cells
Nitrous Oxide Analgesia
Patient Paperwork

Patient Paperwork


To make your first visit less taxing, we've provided our new patient paperwork online.  You can download and filled out these in the comfort of your home.  Many patient with multiple medications will find it easier to get their medications and dosages correct at home.  Please choose "Adult Health History" if the patient is 18 or over and "Minor Health History" if you are bringing a child to the dentist. Both minors and adults must also have an initialed and signed Office Policies and Informed Concent form.

We look forward to seeing you!

New Patient Paperwork - Adult Health History

New Patient Paperwork - Minor Health History

New Patient Paperwork - Office Policies and Inform Concent