Email your saved forms.
Fill out the PDF in an app with Add Text or Fill & Sign, save a copy, then attach the completed file to your email. The button opens your email app; attachments must be added before sending.
Email info@bellroaddentistry.com ↗New patients · Surprise, AZ
Before your visit, feel ready.
Get your new patient paperwork in one place. Complete it digitally, email it to our office, or bring printed copies.
Find your forms
Start here
Your paperwork, all in one place.
Choose the complete packet or download forms individually. Our team will let you know which forms apply to your appointment. Fill them out in a PDF app, or print and write on them by hand.
Patient forms
Get ready at your own pace.
Start with Patient Information and Health History. The complete packet includes all seven documents; our team will confirm which additional forms you need.
One simple download
Download complete packet All your paperwork, together.
Includes a quick guide plus all seven patient documents in one PDF. Complete only the forms our team requests.
Patient details
Patient information
Contact and insurance details for your patient record.
Download PDF · 1 pageHealth & dental historyHealth history
The ADA health and dental history questionnaire.
Download PDF · 2 pagesPractice informationPractice policies and financial agreement
Review our appointment, payment, and treatment policies.
Download PDF · 2 pagesPrivacy informationNotice of privacy practices
Learn how Bell Road Dentistry uses and protects health information.
Download PDF · 2 pagesWhen applicableAuthorization to discuss dental information
Use this if you want us to discuss your care with a family member or friend.
Download PDF · 1 pageAs directed by our teamOral cancer screening consent
Read and sign if our team recommends the screening.
Download PDF · 1 pageAs directed by our teamSTOP-BANG questionnaire
A short sleep apnea risk questionnaire. Complete it if our team asks.
Download PDF · 1 pageOnce you are doneOption one Option two
Choose what works for you.
Print and bring them in.
Print the forms you need, complete them by hand, and bring them to your appointment. We can also help you with paperwork when you arrive.
Completed forms may contain medical, insurance, or Social Security information. Standard email may not be secure. If you prefer another return option, call our team.
Your visit checklist
Bring what helps us care for you.
Photo ID
Bring a current ID so we can confirm your information at check-in.
Insurance details
If you plan to use dental benefits, bring your insurance card or plan information. We can review coverage before treatment.
Medication list
Have an up-to-date list of medications and allergies ready to discuss through our patient paperwork.
Your questions
Tell us about dental concerns, goals, or past experiences. You will have time to talk with our team.
Good to know
Questions before your first visit.
Which forms should I complete?
Start with Patient Information and Health History. Our team will tell you whether any of the other documents apply to your appointment.
Can I email completed forms?
Yes. Save your completed PDF and attach it to an email to info@bellroaddentistry.com. The email button above opens your email app but cannot attach the file for you. Standard email may not be secure; you can bring printed forms instead.
What if I cannot print the forms?
You can use a PDF app’s Add Text or Fill & Sign tool, then save and email the completed PDF. Or call us before your visit and we can help you complete the forms at the office.
Do I need an appointment first?
Yes. If you have not scheduled yet, request an appointment and our team will follow up to confirm availability.