Our patient registration forms are available in PDF format below for your convenience. If you have any questions, please contact our office.

New Patient Form Download

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.

Patients with Insurance

If you are a patients who belong to a specific insurance provider, please click the button above for more information.