Patient Registration

 


CareCredit® Dental Financing: I love to smile now / We Accept the CareCredit credit card



If you would like to be a patient in our dental office, please give us the information outlined below. This will help Dr. McArdle treat you more effectively and allow your first visit with us to run as smoothly as possible. You can print out the forms in either of the formats shown below and fill them out before bringing them with you to your first visit, or you can e-mail the completed MS Word versions to several

days before that visit.

 

 

Download the document in Adobe Acrobat or MS Word format below.

Acceptance of Privacy Policy.doc 119.5KB
Acceptance of Privacy Policy.pdf 62.7KB
Dental History.doc 122.0KB
Dental History.pdf 62.5KB
Office Policy On Dental Benefits.doc 119.0KB
Office Policy On Dental Benefits.pdf 116.3KB
Patient Benefit Information.doc 116.5KB
Patient Benefit Information.pdf 60.0KB
Patient Information.doc 127.5KB
Patient Information.pdf 65.3KB
Privacy Policy Notification.doc 121.0KB
Privacy Policy Notification.pdf 66.9KB
Release Of Information Authorization.doc 116.0KB
Release Of Information Authorization.pdf 60.0KB




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Dr. Barry F. McArdle, D.M.D. ~ 118 Maplewood Avenue, The Captain Moses House, Suite B-7, Portsmouth, NH 03801

Questions or Request an Appointment: Contact Us     Phone: 603-430-1010     Email: [email protected]     Website: http://mcardledmd.com