3202 Palm Harbor Blvd. Palm Harbor, Florida 34683 (727) 781-GUMS

Dr. Philip Sherman, DMD – Blog

Patient Forms

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Patient Forms

We want your experience at Breezy Bay Dental to be… a breeze!

If you are coming in for an appointment, there are forms that we will need you to fill out. You can fill these out online by using one of our office kiosks, but if you plan to do so, please come at least 15 minutes ahead of your scheduled appointment to give you ample time to do so.

If you would rather do this paperwork in the comfort of your own home, you may use the links below to access the necessary forms. Please print and complete each form below and bring them when you arrive for your appointment. We’ll take it from there!

Patient Registration Form
Medical History Report Form
HIPAA Release Form
Office Financial Policy Form
HIPAA Privacy Summary

Call us today! (727) 781-4867