Mountain View Dental

Patient Resources

Printable Forms

• HIPAA Notice of Privacy Practices [140 KB pdf]
• Acknowledgement of Receipt of Notice of Privacy Practices [128 KB pdf]
• Consent to Discuss Information with Other Individuals [132 KB pdf]
• Medical & Dental History Form [149 KB pdf]
• Failed Appointment Policy [107 KB pdf]
• Dental Records Request Form [143 KB pdf]

Insurance & Payment

• Financial & Payment Options

Non-Discrimination Policy

• Mountain View Dental Non-Discrimination Policy [272 KB pdf]