New Patients

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


Remember you receive a free 10 minute 
complimentary massage each visit!











Note: If your insurance policy holder is a spouse or parent, we will need the policy holders' employment information, date of birth and social security number in order to process your claims.

Hippa Form
Medical History Form
Patient Registration Form

© 2019 Serenity Dental Spa, LLC    95 Sparta Ave. Newton, NJ 07860

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