You may access the following forms to assist us with your care. Please complete the following form, and click the "Submit" button at the bottom of the form.

Additionally, please read and review the following documents. You may print them and bring them signed, to your appointment.


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*The Patient Rights and Responsibilities form require Adobe Acrobat Reader. Click the Adobe logo above to download.

Nondiscrimination Notice:

Altoona Smiles P.C. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Altoona Smiles P.C. does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.