Call (954) 271-2384

Annette Middelhof, DMD
8200 W Sunrise Blvd
Plantation, FL 33322

Dental Forms

We are happy to offer our forms and applications for download.  Please feel free to print these and fill them out at your convenience before your visit.  Please do not email these forms over the Internet.

Patient Registration

This form needs to be filled out before your first dental appointment.
Click here to download (990 KB)

Medical History

This form needs to be filled out before your first dental appointment.
Click here to download (538 KB)

HIPPA Form

This form is for your general information as required by federal HIPAA laws.
Click here to download (8kB KB)

Notice of Privacy Practices

This document is for your general information as required by federal HIPAA laws.
Click here to download (26 KB)

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