Welcome, 1st Visit & Returning Patients!

We are very proud that you have chosen Dr. Pińero for your periodontal or dental implantology needs. 

COVID-19 Guidelines

1st Patient Visit

Please assist us by providing the following information at the time of your appointment:

• Your referral slip and any X-rays if applicable
• A list of medications you are presently taking
• If you have dental insurance, bring your insurance card to allow us to help you process your claim.

New & Returning Patient Forms

Please download, print, and complete our new patient form prior to your initial visit with Dr. Hector Pinero. If you have any questions regarding the patient form, please contact our office.

• Patient Registration Form
  
  
• Medical / Dental History Form
  
  
• Agreement / Fees & Payment
  
  
• Financial Policy Form
  
  
• Notice of Privacy Practices
  
  
• Acknowledgement of Receipt of Notice of Privacy Practices

To Print these forms, you will need Adobe Acrobat, a free download.

 

X-Rays

If your dentist has taken x-rays, you may request that they send them to our office. If there is not enough time, you may choose to pick them up and bring them with you. Additional x-rays are usually required and will be taken using our digital imaging system.

IMPORTANT: Please alert the office if you have a medical condition that may be of concern prior to your appointment.