2050 Old Hickory Tree Rd. | St Cloud, FL  34772 | 407-556-3969

  general and cosmetic Dentistry

  • Patient Information Forms

{Required for all New Patients & updated yearly by established patients}

  • Medical Clearance

{Required for all patients who may be pregnant, just had surgery, other medical conditions, ask our staff or your Primary Care Provider if unsure}

  • Records Release

{Utilize if you need records from your previous dentist, or if you are moving away from the area} 


{Notice of Privacy Practices for Protected Health Information}

  • Power of Attorney Consent

{Required when a Legal Parent/Guardian can not be present for any dental appointments of their minor child}

  • No Parents in Operatory with child/children

{With your help, it is our mission to lessen, if not remove Dental Phobias}

Monday, Tuesday, Friday
8:30am - 5:30pm

8:30am - 6:00pm

Patient Information, forms & documents

please click the appropriate link for the document or information you are trying to retreive.