Online Dental Patient Forms
Start Your Dental Appointment Sooner.
Established Acton Road dental patients can fill out and submit their patient forms online using this Established Patients Link.
New Acton Road dental patients can use this New Patients Link to quickly and securely fill out their forms.
Warrior and Gardendale dental patients should use the patient forms below. These forms can be printed and filled out at your convenience. Your family can be seen by a dentist sooner thanks to the patient form options provided here. Call the Alabama Family Dentistry office for an appointment. Warrior Road Family Dentistry: 205-647-3181, Acton Road Family Dentistry: 205-823-2258, Gardendale Family Dentistry: 205-631-7301.
- Patient Information
- Responsible Party Information
- Patient Privacy Practices
- Acknowledgement of Receipt of Privacy Practices
- Alternative People Communication Authorization
- Permission to Administer Local Anesthetic & Antibiotics
- Dental Benefit Plan
We accept most all insurances
CareCredit Payment Plans
