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  • Angie's List Award
    Dr. Jack W. Behn has won the Angie’s List’s Super Service Award for General Dentistry.
    "Michelle consistently provides excellent hygiene care. And Dr Behn always finds time to check my teeth and provide his advise."
    Rickh, Coral Springs

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Patient Forms

For your convenience, we have supplied a Health History Form in pdf format.  If you wish, click on the link below, print, complete the form at home, and bring it with you to your first visit!  We look forward to greeting you!

New Patient Registration

Please download, print and complete this form before your first dental appointment.
Click here to download (1.2 MB)
 

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Click here to download (229 KB)
 

HIPAA Form

Please download, print and complete this form before your first dental appointment. This form confirms that you read our Notice of Privacy Practices.
Click here to download (295 KB)



 

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