> New Patient Forms | Vista Dental

Patient Registration/Screening

Pre-screening Questionnaire and New or Update Patient  Forms

 

Prior to the office visit, please take time to fill out the pre-screening questionnaire.  Click  the link below, then click SUBMIT when you are done.

Patient screening questionnaire – Mandatory

After the pre-screening questionnaire, proceed to register or update your information online.  You can click on one of the links below, complete the forms as thoroughly as you can, click SUBMIT when you are done.

Patient Registration – English

Patient Registration – Spanish

Or you can download and fill out the forms below: You can type into the forms, save, print and sign.  Please bring the signed forms with you to your appointment.

English:
PDF New Patient Packet

Espanol:
PDF Paquete de paciente nuevo

 

These forms are downloaded with Acrobat Reader. Please click the image below to download the free reader.

get_adobe_reader

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Vista Dental
3960 W Craig Rd #110
North Las Vegas, NV 89032
(702) 464-3000
Email: vistadentalvegas@gmail.com
Monday, Tues, Thursday: 9am-6pm
Wed, Friday: 9am-1pm
Other times by appt.