• Longmont CO Dental office
    Enter to WIN an iPad
    or Flat Screen TV!
  • Family Dentistry Special Offer

    FREE Initial Examination and full mouth Xrays
    (a $175 value)
    FREE Sonicare Toothbrush after initial exam, cleaning, and Xrays. 

    To take advantage of the amazing offer, simply complete the form below.
    Cannot be combined with any other offers.

    Offer Expires:  08/27/2018

Patient Forms

For your convenience, we have supplied our patient registration forms in PDF format.

Simply click on the link below to download the Printable PDF forms. Please call our office if you have any questions.

The Health Insurance Privacy and Portability Act (HIPAA) is a federal law designed to protect your personal health information. Kurt W. Knechtel, DMD Family and Cosmetic Dentistry is HIPAA compliant. We have provided a printable version of our HIPAA Notice of Privacy Practices and Acknowledgement forms. For new patients, please print, sign and bring the Acknowledgement form to your first visit.

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