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Patient Forms

We are pleased that you have chosen us to care for your teeth. Our entire team of dental professionals is dedicated to providing you with individual care. To help us learn more about your dental needs, please print and fill out the application patient information form(s) before your appointment.

Please select the form(s) below, print, fill-out, and bring it to your appointment.

Franklin Dental Associates Medical Form

Franklin Dental Associates Financial Agreement

Covid-19 Questionnaire

FDA-HIPAA-Acknowledgement

HIPAA Privacy Notice

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VIP Program
No Insurance?
Join our Franklin Dental VIP Program and get your preventive care for a low monthly subscription fee.
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Is Cost a Concern?
We offer patient financing through CareCredit® to help get you the care you need.