At Wayne & Julie Scott DDS, PA, we offer patient forms online so you can complete them in the convenience of your own home or office. The forms are electronic and can be completed on a desktop computer. They will need to be saved and emailed to office@wjscottdds.com or you may bring them during your visit. You may also complete them online (desktop & mobile compatible): https://forms.patientconnect365.com/20514
All forms need to be completed prior to your scheduled appointment time. If you are unable to send in your completed forms, you will need to arrive at least 20 minutes early to your scheduled appointment time. Forms not completed will result in a delay to your appointment and all services may not be completed the same day (this will be dependent on the amount of time left in the allotted time for your appointment).
New Patients/Returning Patients (To be completed if it’s been 2 or more years since your last appointment or 3+ years since forms were last completed)
Complete ALL forms
- Patient Information – Download & Print or Complete Online
- New Patient Health History – Download & Print or Complete Online
- Financial & Office Policies – Download & Print or Complete Online
- HIPAA Consent Form – Download & Print or Complete Online
- HIPAA Notice of Privacy Practices – Download & Print (Print only if you wish to retain copy)
Existing Patients (To be completed every 12mos and/or after a significant change to your health)
- Medical History Update Form – Download & Print or Complete Online
Do You Have Dental Insurance (or a change to your insurance)?
- Dental Insurance Form – Complete Online
In lieu of completing the insurance form, you may send us a picture of the front & back of your card. Please also include the policy holder’s name and DOB. Text: 972-627-4473 or email: office@wjscottdds.com
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