PATIENT FORMS
We look forward to your visit!
Medical History Form
Please download and print the PDF form for your medical history and bring it to your Perio Health Partners appointment.
Pre-Operative Instructions
Please download and print the PDF form for your pre-operative instructions and bring it to your Perio Health Partners appointment.
Post-Operative Instructions
Please download and print the PDF form for your post-operative instructions and bring it to your Perio Health Partners appointment.
Patient Consent Form
Please download and print the PDF form for your patient consent and bring it to your Perio Health Partners appointment.
Notice of Privacy Practices
This is our Notice of Privacy Practices: Please download and print the PDF form and bring it to your Perio Health Partners appointment.
office financial policy
This is our office financial policy: Please download and print the PDF form and bring it to your Perio Health Partners appointment.
dental insurance information
This is our dental insurance information form: Please download and print the PDF form and bring it to your Perio Health Partners appointment.
DID YOU KNOW…?
- All of our patients are carefully screened first to determine if they are periodontal or implant candidates
- Medical history, dental history, necessary x-rays and clinical evaluations are performed
- We communicate with the restoring dentist to come up with the ideal treatment plan
- Diagnostic models are then used to plan your treatment and determine the best option for you
- For precise implant planning, a surgical stent (guide) is created, allowing for optimal implant position
- Implant evaluations are meticulously planned with your restorative dentist to create a highly esthetic and predictable treatment outcome
PRE AND POST-OPERATION




Our Location
1815 S. Clinton Ave.
Building 500, Suite 500
Rochester, NY 14618
585-376-5300
info@periohealthpartners.com