A collection of pens on the dentist office desk for patients to fill out medical forms including three safari themed carved wooden pens of a tiger, zebra, and warthog.

Patient Forms

Please complete these forms and return them to our office before your visit.

How to complete these forms

Click one of the links below to download the form you wish to complete.

Once you have downloaded the form, you can complete the form by filling in the fields directly in the PDF file, or by printing out the blank form and completing it by hand.

Once you have completed the form, you can return it to us by emailing a copy of the completed form to PatientCare@SusanTiksonDDS.com, or by bringing the form in and giving it to us in person.

We encourage patients to please submit forms via email when possible.

Forms available for download

New Patient Form

Please fill this form out prior to your first visit if you are a new patient.

Please email the completed form to PatientCare@SusanTiksonDDS.com.

Returning Patient Medical History Update Form

Please fill this form out prior to your visit if you are a returning patient.

Please email the completed form to PatientCare@SusanTiksonDDS.com.

COVID Form

To help keep everyone safe during this pandemic, please fill this form out prior to your visit.

Please email the completed form to PatientCare@SusanTiksonDDS.com.