Contact Us: (863) 382-8878
4660 Lakeview Drive, Suite 102, Sebring, FL 33870

Patient Forms

Thank you for allowing Heartland Periodontics the opportunity to provide for your periodontal and dental implant needs. Our staff is comprised of trained professionals who work as a team to ensure that your treatment with us is delivered with care, comfort, and excellence.

We understand that coming to a specialist can cause patients to be apprehensive about dental treatment. To help lessen that feeling, please look over the Heartland Periodontics website. If you should have any questions prior to your appointment, please do not hesitate to call our office as we will be happy to answer any of your questions.

Below this statement you will find our medical history forms. Your well-being is important to us while in our care; therefore, your answers will help us customize your treatment to protect your health.

As part of our commitment to excellence to you, our patient, we promise to treat you with the respect and understanding that you deserve. We look forward to the opportunity of meeting you soon.

Patient Forms

To continue making your dental experience pleasant, we have conveniently provided our dental forms below, so that you can fill them out in the comfort of your home and securely submit them to our office.

New Patient Forms

Medical History

Notice Of Privacy Practices

Formularios para pacientes

Para que su experiencia dental siga siendo agradable, le facilitamos nuestros formularios dentales a continuación, para que pueda completarlos cómodamente en su hogar y enviarlos de forma segura a nuestra oficina.

Nuevos formularios para pacientes

Historial Médico

Aviso de prácticas de privacidad