New Patient Registration

If you’ve never seen us before, sign up today for new patient specials and options!

New Patient Sign Up Form

Form on New Patient Sign Page

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Do not fill this form out if you're a solicitor.

Name*

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Email*

Phone*

Address*

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Questions/Comments

Please do not send us any specific personal health information, and, if you would like to speak about dental or health conditions, please call our office.

Before Your Appointment

We recommend printing the forms below and filling them about before you arrive at Rocky Mountain Smiles

Authorization to Release Dental Information
New Patient Form