Patient Forms

In the age of technology and doing all we can to decrease the spread of germs with unnecessary papers, we are very pleased to offer you a safe and convenient way to do your paperwork. This will also allow us to be fully prepared when you arrive for your appointment. Please click on the link you need below to get started. We ask that you fill everything out fully so we have the most up-to-date information to be able to serve your needs.

Please complete and email them to us at info@bacsadental.com or call us with any questions.

We look forward to seeing you!

Adult Medical History Forms

Adult New Patient Forms

Child Medical History Forms

Child New Patient Forms

Dental History Forms

Dental Insurance Forms

Financial Agreement Forms

HIPPA Forms

What Our Patients Say

Randi B.

I've been seeing Dr. Bacsa for years now. In the past, I've had severe dental phobia, but the atmosphere is so relaxed and everyone is so kind.

Scott T.

I have consistently had 5-star experiences with Dr. Bacsa and his staff. They are kind, professional, and capable. I highly recommend them.

Jo T.

I am new to the office this year and have been very impressed with the friendly staff. The office is spotless and very pleasant to visit.

Watch our patient testimonial videos.