WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

health_resources.pngFort Mohave Dental offers our patient form(s) online so they can be completed it in the convenience of your own home or office. Follow these easy three steps:

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Bring them with you to your appointment.

New Dental Patient Form - Required

This lets us know the history and current state of your dental health.  Download and print this form,then fill it out if you are coming in for general dentistry. It will speed up your first visit.

New Patient

For TMJ problems download the TMJ scale and print and fill out and bring to your first visit..

TMJ Scale

For TMJ problems fill out the online questions for TMJ by clicking the TMJ Questions link. Then let us know when your done.

TMJ Questions

For Snoring/Sleep Apnea click on sleep questions 1 and fill out the questions then click on sleep questions 2 and fill out the questions then call and let us know your done.

Sleep questions 1

Sleep questions 2

For Periodontal treatment fill in the questions by clicking on the perio questions link.

Perio questions

Download the Free AdobeReader®