New Patient Forms

What you should know about your first visit to Dr. Mellas’ office.

Prior to your exam, you will complete a health history which helps us identify oral and overall health issues we should watch out for. The form is available on this page. While you may be surprised at the thoroughness of the form, we believe it is important we have all relevant information as part of healthcare team, and it is an important step in helping us care for you properly.

What you should bring to your first visit:

1. Dental insurance card, if applicable

2. Photo ID card

3. Completed new patient forms

Instructions for New Patient Form

We’ll need the information on the form prior to getting started. Please download and complete the form below and bring it to your first visit. If you are not able to complete these forms prior to your first visit, please arrive 30 minutes before your scheduled appointment.

The form is a PDF and requires you have Adobe Reader to open it. (Nearly all computers have this. If you cannot open the form, you can download it here:   Adobe Reader.)

After opening the form, you can place your cursor in the text fields and type your answers. You can also click the appropriate selections to choose Yes/No, etc.

To print the form from your computer:

1. Choose File > Print or click   icon in the toolbar

2. Select a Printer

3. Click Print

Doctor Referral Form