Patient Forms

PATIENT REVIEWS

Online Forms

At Cosmetic Dental Specialties, we sincerely believe you will find our approach to your care to be extraordinarily unique and contemporary. Above all, when you walk through our doors you will be treated with the utmost compassion and respect. We are delighted to have you as a patient and we welcome you to our practice.Please fill out and submit online the Patient Registration and HIPAA Forms prior to coming to our office; or print, fill them out and then bring them with you to your appointment. This will save you office waiting time.For physicians who are kindly referring patients to us, please feel free to submit the Referral Form.

Patient Medical History Form

Patient Insurance Form

HIPAA Form

Referral Form

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PATIENT REVIEWS

My husband and I both needed extensive dental work…and so, we actually flew to New York to see Dr. Edalat, after meeting one of his students who had raved about Dr. Edalat and his office. Both my husband and I feel and look so much better after our treatment. We wouldn’t dream of seeing any other dentist ever again!”

Louise C. – Kent, England

Patient Forms

treatments

PATIENT REVIEWS

Online Forms

Patient Medical History Form

Patient Insurance Form

HIPAA Form

Referral Form

PATIENT REVIEWS