Dr. Ed de la Paz

 

 PRINTABLE OFFICE FORMS

Thank you for allowing my staff and I to provide for your dental care. We pledge to offer you the highest level of care and service as we strive to meet your dental health needs. Below you will find links to all of our Patient Office Forms if you would prefer to print out forms. Please note that all of these forms may also be accessed, filled out and directly submitted electronically to our office via our website. The choice is yours. If you elect to print any forms that are required, you may bring the forms with you to your next appointment or you can scan and e-mail the completed forms to Stephani Burris or Penny Jordan (drdelapaz-office@tampabay.rr.com). As always, if you require any assistance, please give us a call at 813-930-8300. We look forward to seeing soon.

Patient Registration

Health History

Dental History

01-_Notice_of_Privacy_Practices

02-_Ackowledgment_of_Receipt_of_Notice_of_Privacy_Practices.pdf

03-_Consent_for_Release_of_Medical_Records_and_Information.pdf

 

 

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