Clairemont Endodontics

Patient Forms

PRE-APPOINTMENT INSTRUCTIONS

1. Please bring a completed set of New Patient Forms (above) with you to your appointment; we also need the referral slip provided by your dentist

2. Avoid any pain medication 8 hours prior to your visit

3. Please be prepared to pay your appropriate treatment fee, in full, the day of your appointment

4. We require at least 24-hours’ notice if change of appointment is absolutely necessary

5. All patients will need to provide a valid photo ID and an insurance card (if applicable)

If you have any questions regarding your appointment, do not hesitate to call the office. We look forward to meeting you!

Patient Registration

Privacy Practices (printing optional) ​

Post-Op Instructions ​

Take Our Patient Survey

Have Questions? Get in Touch
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