Patient Forms

We are dedicated to minimize your Wait Time.

Please print out the form below and fill out to bring in to your first appointment. Thank you and we are looking forward to seeing you soon.

Office Map

Patient Information Forms

Office Map (PDF) | Ogden Dentist - Dr. Ellis

Office Map (PDF)
Ogden Dentist – Dr. Jim Ellis

File size: 585 KB

Patient Information Form (PDF) | Ogden Dentist - Dr. Ellis

Patient Information Forms (PDF)
Ogden Dentist – Dr. Jim Ellis

File size: 1.91 MB

Other Legal Forms

Patient's Medical History Form (PDF)

Patient’s Medical History Form (PDF)
File size: 20 KB

Informed Consent Oral Surgery and Dental Extractions (PDF)

Informed Consent Oral Surgery and Dental Extractions (PDF)
File size: 20 KB

Consent for Use and Disclosure of Health Information (PDF)

Consent for Use and Disclosure of Health Information (PDF)
File size: 94 KB

**You will need the Adobe Acrobat Reader to open these files. You can download it free from Adobe by clicking on the link: http://get.adobe.com/reader