20 Newman Ave. Rumford RI 02916 - (401) 434-4304
New Patient Registration Forms
Please feel free to download our new patient registration forms and brig them to your first appointment.

2014_2015_new_pt_packet.pdf |
Medical History Form
For patients returning to the office, if it has been more than a year, or if you have had any recent medical changes we should be aware of, please complete a new medical history form and bring it to your next appointment.

2014_blank_medical_history.pdf |
Rumford Dental HIPPA Form
If you would like a copy of our complete HIPPA form for your own information, you may download it here. We also have a copy in the office if you would like to view it during your appointment.

complete_hippa_form.pdf |