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Patient Forms


 

NEW PATIENTS

Please access our new patient paperwork through our secure forms system and submit your information to our office before your appointment.

NEW PATIENT PAPERWORK

CANCELLATION POLICY

 

EXISTING PATIENTS

If our staff requests that you submit any other forms related to your treatment, please submit the requested consent / assessment form(s) from the list below:

 

RECORDS RELEASE

If you would like to request the release of your patient history / records to another provider, please fill out the appropriate forms below:

Location
Tompkins Dental
2309 North Triphammer Road
Located in the Cayuga Mall

Ithaca, NY 14850
Phone: 607-257-8065
Office Hours

Get in touch

607-257-8065