303-678-5253 • 1055 17th Ave. Ste. 101, Longmont, CO info@longmontperiodontics.com


The following forms and have been provided for your convenience. Please note that these forms may not be the appropriate forms for all patients in all circumstances.

New patients can save time during their first appointment by completing these forms prior to their visit. Please bring the completed forms with you to your appointment.

Patient History & Information

HIPAA Acknowledgement Form

Financial Policy