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New Patient Forms at Midland Park Family Dentistry

Man filling out forms

Save time during your first visit

At Midland Park Family Dentistry, we offer our paperwork online so you can complete it in the convenience of your own home.

Please see below to access our New Patient Form and Record Release Form.
Note that there are two pages within our New Patient Form – patient registration and medical history. Please fill out both of them.

New Patient Form

Records Release Form

HIPAA Notice


New Patient Forms at Midland Park Family Dentistry| (201) 389-8418