{"id":428,"date":"2018-01-03T02:16:36","date_gmt":"2018-01-03T02:16:36","guid":{"rendered":"http:\/\/www.dentalassociatesofdelaware.com\/?page_id=428"},"modified":"2024-03-22T10:57:24","modified_gmt":"2024-03-22T15:57:24","slug":"patient-forms","status":"publish","type":"page","link":"https:\/\/dentalassociatesofdelaware.com\/patient-info\/patient-forms\/","title":{"rendered":"Patient Forms"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column css=&#8221;.vc_custom_1516049134393{padding-right: 30px !important;padding-left: 30px !important;}&#8221;]<div class=\"ult-spacer spacer-662dc7b6aab59\" data-id=\"662dc7b6aab59\" data-height=\"30\" data-height-mobile=\"30\" data-height-tab=\"30\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: left; font-size: 36px; color: #003e75;\"><strong>Patient Forms<\/strong><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aac6a\" data-id=\"662dc7b6aac6a\" data-height=\"40\" data-height-mobile=\"40\" data-height-tab=\"40\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]The family and cosmetic dentists at <a href=\"https:\/\/dentalassociatesofdelaware.com\/\">Dental Associates of Delaware<\/a> look forward to meeting you during your first visit to our dentistry offices in Brandywine, Hockessin, Middletown, Wilmington, or Millsboro, DE. At your first visit with us, one of our friendly team members will help you to get acquainted with the office and answer any questions that you might have. Our dentists are committed to providing you and your family with comfortable, safe and high quality dental care, from routine cleanings to cosmetic dentistry and dental implants.[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aad5d\" data-id=\"662dc7b6aad5d\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]If you are coming from within Brandywine, Hockessin, Middletown, Wilmington, Millsboro, DE or driving a bit further from one of the surrounding towns throughout Delaware, we know that your time is valuable and want to make sure that your first appointment is easy and efficient. In order to expedite the process, we have posted our patient forms below for you to print, fill out and bring with you to your first visit.[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aad83\" data-id=\"662dc7b6aad83\" data-height=\"40\" data-height-mobile=\"30\" data-height-tab=\"30\" data-height-tab-portrait=\"30\" data-height-mobile-landscape=\"30\" style=\"clear:both;display:block;\"><\/div>[vc_row_inner gap=&#8221;25&#8243; css=&#8221;.vc_custom_1611076073909{padding-right: 20px !important;padding-left: 20px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;]<div class=\"ult-spacer spacer-662dc7b6aada4\" data-id=\"662dc7b6aada4\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><strong>Brandywine<br \/>\nOffice<\/strong><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aadc2\" data-id=\"662dc7b6aadc2\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\">302.477.4900<\/p>\n<p style=\"text-align: center; font-size: 12px;\">1415 Foulk Rd., Suite 200<br \/>\nWilmington, DE 19803<\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aade1\" data-id=\"662dc7b6aade1\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-custom \" href=\"https:\/\/patientregistration.denticon.com\/?P=4865&O=101&regPatID=0\" target=\"_blank\" rel=\"noopener\" ><button type=\"button\" id=\"ubtn-2360\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-custom ubtn-no-hover-bg  none  ubtn-center   tooltip-662dc7b6aae23\"  data-hover=\"#134f7d\" data-border-color=\"#134f7d\" data-bg=\"#134f7d\" data-hover-bg=\"#ffffff\" data-border-hover=\"#134f7d\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-2360'  data-responsive-json-new='{\"font-size\":\"desktop:20px;\",\"line-height\":\"desktop:26px;\"}'  style=\"font-weight:normal;width:280px;min-height:52px;padding:8px 6px;border-radius:4px;border-width:2px;border-color:#134f7d;border-style:solid;background: #134f7d;color: #ffffff;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >New Patient Registration<\/span><\/button><\/a><\/div><div class=\"ult-spacer spacer-662dc7b6aaefa\" data-id=\"662dc7b6aaefa\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1514951784670{padding-right: 10px !important;padding-left: 10px !important;}&#8221;]<div class=\"ult-spacer spacer-662dc7b6aaf2f\" data-id=\"662dc7b6aaf2f\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><strong>Hockessin<br \/>\nOffice<\/strong><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aaf4a\" data-id=\"662dc7b6aaf4a\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\">302.239.5917<\/p>\n<p style=\"text-align: center; font-size: 12px;\">500 Lantana Dr.<br \/>\nHockessin, DE 19707<\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aaf5d\" data-id=\"662dc7b6aaf5d\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-custom \" href=\"https:\/\/patientregistration.denticon.com\/?P=4865&O=103&regPatID=0\" target=\"_blank\" rel=\"noopener\" ><button type=\"button\" id=\"ubtn-6561\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-custom ubtn-no-hover-bg  none  ubtn-center   tooltip-662dc7b6aaf88\"  data-hover=\"#134f7d\" data-border-color=\"#134f7d\" data-bg=\"#134f7d\" data-hover-bg=\"#ffffff\" data-border-hover=\"#134f7d\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-6561'  data-responsive-json-new='{\"font-size\":\"desktop:20px;\",\"line-height\":\"desktop:26px;\"}'  style=\"font-weight:normal;width:280px;min-height:52px;padding:8px 6px;border-radius:4px;border-width:2px;border-color:#134f7d;border-style:solid;background: #134f7d;color: #ffffff;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >New Patient Registration<\/span><\/button><\/a><\/div><div class=\"ult-spacer spacer-662dc7b6aafc8\" data-id=\"662dc7b6aafc8\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243;]<div class=\"ult-spacer spacer-662dc7b6aafe4\" data-id=\"662dc7b6aafe4\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><strong>Middletown<br \/>\nOffice<\/strong><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6aaff4\" data-id=\"662dc7b6aaff4\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\">302.378.8600<\/p>\n<p style=\"text-align: center; font-size: 12px;\">106 St Anne\u2019s Church Rd.<br \/>\nMiddletown, DE 19709<\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab003\" data-id=\"662dc7b6ab003\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-custom \" href=\"https:\/\/patientregistration.denticon.com\/?P=4865&O=102&regPatID=0\" target=\"_blank\" rel=\"noopener\" ><button type=\"button\" id=\"ubtn-5077\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-custom ubtn-no-hover-bg  none  ubtn-center   tooltip-662dc7b6ab026\"  data-hover=\"#134f7d\" data-border-color=\"#134f7d\" data-bg=\"#134f7d\" data-hover-bg=\"#ffffff\" data-border-hover=\"#134f7d\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-5077'  data-responsive-json-new='{\"font-size\":\"desktop:20px;\",\"line-height\":\"desktop:26px;\"}'  style=\"font-weight:normal;width:280px;min-height:52px;padding:8px 6px;border-radius:4px;border-width:2px;border-color:#134f7d;border-style:solid;background: #134f7d;color: #ffffff;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >New Patient Registration<\/span><\/button><\/a><\/div><div class=\"ult-spacer spacer-662dc7b6ab06a\" data-id=\"662dc7b6ab06a\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][\/vc_row_inner]<div class=\"ult-spacer spacer-662dc7b6ab07d\" data-id=\"662dc7b6ab07d\" data-height=\"20\" data-height-mobile=\"15\" data-height-tab=\"15\" data-height-tab-portrait=\"15\" data-height-mobile-landscape=\"15\" style=\"clear:both;display:block;\"><\/div>[vc_row_inner gap=&#8221;25&#8243; css=&#8221;.vc_custom_1611076073909{padding-right: 20px !important;padding-left: 20px !important;}&#8221;][vc_column_inner width=&#8221;1\/3&#8243;]<div class=\"ult-spacer spacer-662dc7b6ab08d\" data-id=\"662dc7b6ab08d\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><strong>Wilmington<br \/>\nOffice<\/strong><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab09c\" data-id=\"662dc7b6ab09c\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\">302.658.9511<\/p>\n<p style=\"text-align: center; font-size: 12px;\">1304 N. Broom St.<br \/>\nWilmington, DE 19806<\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab0aa\" data-id=\"662dc7b6ab0aa\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-custom \" href=\"https:\/\/patientregistration.denticon.com\/?P=4865&O=106&regPatID=0\" target=\"_blank\" rel=\"noopener\" ><button type=\"button\" id=\"ubtn-5929\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-custom ubtn-no-hover-bg  none  ubtn-center   tooltip-662dc7b6ab0cb\"  data-hover=\"#134f7d\" data-border-color=\"#134f7d\" data-bg=\"#134f7d\" data-hover-bg=\"#ffffff\" data-border-hover=\"#134f7d\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-5929'  data-responsive-json-new='{\"font-size\":\"desktop:20px;\",\"line-height\":\"desktop:26px;\"}'  style=\"font-weight:normal;width:280px;min-height:52px;padding:8px 6px;border-radius:4px;border-width:2px;border-color:#134f7d;border-style:solid;background: #134f7d;color: #ffffff;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >New Patient Registration<\/span><\/button><\/a><\/div><div class=\"ult-spacer spacer-662dc7b6ab1a0\" data-id=\"662dc7b6ab1a0\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243;]<div class=\"ult-spacer spacer-662dc7b6ab1b1\" data-id=\"662dc7b6ab1b1\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><strong>Millsboro<br \/>\nOffice<\/strong><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab1c5\" data-id=\"662dc7b6ab1c5\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\">302.934.8005<\/p>\n<p style=\"text-align: center; font-size: 12px;\">28318 Dupont Blvd.<br \/>\nMillsboro, DE 19966<\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab1d3\" data-id=\"662dc7b6ab1d3\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\" ubtn-ctn-center \"><a class=\"ubtn-link ult-adjust-bottom-margin ubtn-center ubtn-custom \" href=\"https:\/\/patientregistration.denticon.com\/?P=4865&O=107&regPatID=0\" target=\"_blank\" rel=\"noopener\" ><button type=\"button\" id=\"ubtn-7778\"  class=\"ubtn ult-adjust-bottom-margin ult-responsive ubtn-custom ubtn-no-hover-bg  none  ubtn-center   tooltip-662dc7b6ab1f5\"  data-hover=\"#134f7d\" data-border-color=\"#134f7d\" data-bg=\"#134f7d\" data-hover-bg=\"#ffffff\" data-border-hover=\"#134f7d\" data-shadow-hover=\"\" data-shadow-click=\"none\" data-shadow=\"\" data-shd-shadow=\"\"  data-ultimate-target='#ubtn-7778'  data-responsive-json-new='{\"font-size\":\"desktop:20px;\",\"line-height\":\"desktop:26px;\"}'  style=\"font-weight:normal;width:280px;min-height:52px;padding:8px 6px;border-radius:4px;border-width:2px;border-color:#134f7d;border-style:solid;background: #134f7d;color: #ffffff;\"><span class=\"ubtn-hover\" style=\"background-color:#ffffff\"><\/span><span class=\"ubtn-data ubtn-text \" >New Patient Registration<\/span><\/button><\/a><\/div><div class=\"ult-spacer spacer-662dc7b6ab23c\" data-id=\"662dc7b6ab23c\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/3&#8243;][\/vc_column_inner][\/vc_row_inner][vc_row_inner gap=&#8221;25&#8243; css=&#8221;.vc_custom_1611075949266{padding-right: 30px !important;padding-left: 30px !important;}&#8221;][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"ult-spacer spacer-662dc7b6ab251\" data-id=\"662dc7b6ab251\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/01\/Financial-Policy-Form-updated-2017-July-For-Website-NO-signature-lines-1.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Financial Policies<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab26a\" data-id=\"662dc7b6ab26a\" data-height=\"45\" data-height-mobile=\"20\" data-height-tab=\"30\" data-height-tab-portrait=\"40\" data-height-mobile-landscape=\"20\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;521&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/01\/Financial-Policy-Form-updated-2017-July-For-Website-NO-signature-lines-1.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab282\" data-id=\"662dc7b6ab282\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1514951784670{padding-right: 10px !important;padding-left: 10px !important;}&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab28f\" data-id=\"662dc7b6ab28f\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/01\/2011-03-Sleep-Evaluation.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Sleep Evaluation Form (For our Brandywine Office)<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab29f\" data-id=\"662dc7b6ab29f\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;558&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/01\/2011-03-Sleep-Evaluation.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab2ab\" data-id=\"662dc7b6ab2ab\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"ult-spacer spacer-662dc7b6ab2b7\" data-id=\"662dc7b6ab2b7\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/2018-02-Notice-of-Privacy-Practices-DAD-NPP-07012017.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">HIPAA Privacy Notice<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab2c4\" data-id=\"662dc7b6ab2c4\" data-height=\"43\" data-height-mobile=\"20\" data-height-tab=\"30\" data-height-tab-portrait=\"40\" data-height-mobile-landscape=\"20\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;2295&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/2018-02-Notice-of-Privacy-Practices-DAD-NPP-07012017.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab2d0\" data-id=\"662dc7b6ab2d0\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"ult-spacer spacer-662dc7b6ab34b\" data-id=\"662dc7b6ab34b\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/2018-02-HIPAA-Acknowledgement-Receipt-updated.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">HIPAA Acknowledgement Receipt<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab357\" data-id=\"662dc7b6ab357\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;2289&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/2018-02-HIPAA-Acknowledgement-Receipt-updated.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab361\" data-id=\"662dc7b6ab361\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner css=&#8221;.vc_custom_1514951774326{padding-right: 10px !important;padding-left: 10px !important;}&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab36c\" data-id=\"662dc7b6ab36c\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][\/vc_row_inner][vc_row_inner gap=&#8221;25&#8243; css=&#8221;.vc_custom_1611076004274{padding-right: 30px !important;padding-left: 30px !important;}&#8221;][vc_column_inner width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1514951774326{padding-right: 10px !important;padding-left: 10px !important;}&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab37b\" data-id=\"662dc7b6ab37b\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/Notice-of-Nondiscrimination.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Notice of Nondiscrimination<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab387\" data-id=\"662dc7b6ab387\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"30\" data-height-tab-portrait=\"40\" data-height-mobile-landscape=\"20\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;2299&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/Notice-of-Nondiscrimination.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab391\" data-id=\"662dc7b6ab391\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1514951784670{padding-right: 10px !important;padding-left: 10px !important;}&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab39a\" data-id=\"662dc7b6ab39a\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/Taglines-Delaware-Top-15-Languages.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Taglines &#8211; Delaware Top 15 Languages<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab3a4\" data-id=\"662dc7b6ab3a4\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;2301&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/Taglines-Delaware-Top-15-Languages.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab3ac\" data-id=\"662dc7b6ab3ac\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;]<div class=\"ult-spacer spacer-662dc7b6ab3b5\" data-id=\"662dc7b6ab3b5\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/2018-03-DAD-Authorization-Release-of-info-to-family.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">DAD Authorization Release of info to family<\/a><\/p>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab3bf\" data-id=\"662dc7b6ab3bf\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"30\" data-height-tab-portrait=\"40\" data-height-mobile-landscape=\"20\" style=\"clear:both;display:block;\"><\/div>[vc_single_image image=&#8221;2303&#8243; img_size=&#8221;245&#215;330&#8243; alignment=&#8221;center&#8221; style=&#8221;vc_box_border&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/dentalassociatesofdelaware.com\/wp-content\/uploads\/2018\/05\/2018-03-DAD-Authorization-Release-of-info-to-family.pdf&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab3d2\" data-id=\"662dc7b6ab3d2\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;1\/4&#8243;][\/vc_column_inner][\/vc_row_inner]<div class=\"ult-spacer spacer-662dc7b6ab3df\" data-id=\"662dc7b6ab3df\" data-height=\"60\" data-height-mobile=\"30\" data-height-tab=\"\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"30\" style=\"clear:both;display:block;\"><\/div>[vc_row_inner][vc_column_inner width=&#8221;1\/4&#8243;][vc_single_image image=&#8221;565&#8243; img_size=&#8221;large&#8221; alignment=&#8221;center&#8221; onclick=&#8221;custom_link&#8221; img_link_target=&#8221;_blank&#8221; link=&#8221;https:\/\/get.adobe.com\/reader\/&#8221;]<div class=\"ult-spacer spacer-662dc7b6ab3ea\" data-id=\"662dc7b6ab3ea\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][vc_column_inner width=&#8221;3\/4&#8243;][vc_column_text]*These dental forms require Adobe Acrobat Reader. Click the Adobe logo to download.[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab3f1\" data-id=\"662dc7b6ab3f1\" data-height=\"20\" data-height-mobile=\"20\" data-height-tab=\"20\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column_inner][\/vc_row_inner]<div class=\"ult-spacer spacer-662dc7b6ab3fa\" data-id=\"662dc7b6ab3fa\" data-height=\"60\" data-height-mobile=\"30\" data-height-tab=\"\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"30\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]<\/p>\n<h2>Contact Our Delaware Family &amp; Cosmetic Dentistry Offices<\/h2>\n<p>[\/vc_column_text]<div class=\"ult-spacer spacer-662dc7b6ab401\" data-id=\"662dc7b6ab401\" data-height=\"10\" data-height-mobile=\"10\" data-height-tab=\"10\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[vc_column_text]If you have any questions about your first visit or the forms that we have provided above, please don&#8217;t hesitate to contact our Brandywine office, Hockessin office, Middletown office, Wilmington office, or Millsboro office. Our dentists and their skilled team are always happy to meet new patients and welcome you to the Dental Associates of Delaware family. We look forward to seeing you in one of our offices soon![\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column]<div class=\"ult-spacer spacer-662dc7b6ab407\" data-id=\"662dc7b6ab407\" data-height=\"50\" data-height-mobile=\"50\" data-height-tab=\"50\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div>[\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column css=&#8221;.vc_custom_1516049134393{padding-right: 30px !important;padding-left: 30px !important;}&#8221;][vc_column_text] Patient Forms [\/vc_column_text][vc_column_text]The family and cosmetic dentists at Dental Associates of Delaware look forward to meeting you during your first visit to our dentistry offices in Brandywine, Hockessin, Middletown, Wilmington, or Millsboro, DE. At your first visit with us, one of our friendly team members will help you to&hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":34,"menu_order":20,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Patient Forms Dental Associates of Delaware | Five Dental Locations in DE<\/title>\n<meta name=\"description\" content=\"Fill out our patient forms before your visit to our Brandywine, Hockessin, Middletown, Wilmington, or Millsboro, DE dental offices of Dental Associates of Delaware.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dentalassociatesofdelaware.com\/patient-info\/patient-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" 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