New Patients

Please fill out information and hand it to the
receptionist on your first day at our office.

Hippa Form
Medical History Form
Patient Registration Form
Note: If your insurance policyholder is a spouse or parent, we will need the policyholders' employment information, date of birth, and social security number in order to process your claims.

© 2020 Serenity Dental Spa, LLC    95 Sparta Ave. Newton, NJ 07860

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