Download Forms

We are delighted to welcome you to our practice and are pleased that you chose us to serve your dental needs.

New Patient Questionaire

Notice of Privacy Practices (PDF)
This form presents the information that federal law requires us to give our patients regarding our privacy practices. Please read this form before your appointment.

Acknowledgement of Receipt of Notice of Privacy Practices (PDF)
This form is used to obtain acknowledgement of receipt of our Notice of Privacy Practices or to document our good faith effort to obtain that acknowledgement. Please print, read carefully, sign, and bring with you to your scheduled appointment.

Patient Information (PDF)
This form is to familiarize Dr. Lecca with both your general and personal information, as well as medical history. Please print, read carefully, and sign where necessary. Remember to bring it with you to your scheduled appointment.

Fact Sheet
This fact sheet is to inform you about the importance of oral health.