Patient Forms


Receptionist Smiling

Thank you for choosing us at Keelan Dental, where your convenience and comfort are of the utmost importance. We appreciate you scheduling an appointment and look forward to meeting you and your entire family. Before you visit our office, we encourage you to fill out the patient forms provided below. By gathering your information before your visit, we can streamline your experience, so you spend less time preparing and waiting for your visit and more one-on-one time with our compassionate, friendly dentist and team. If you have questions or experience problems with our online forms, please contact us immediately, so that we may assist you.

Online Patient Form

Please click on the links below to download our forms. Please print and complete the forms before your appointment. Please bring the completed forms to your appointment, along with your insurance card. If you are unable to print the forms, please plan to arrive 10-15 minutes early for your appointment so that you can complete them in our office.

HIPAA Policy
Records Release Form