FIANT FORMS

We’re happy that you’ll be visiting us soon. Help us get to know you, and get your Fiant Dental record established. Please click the link below to fill out our online registration. Or you can print, fill out and bring with to your first appointment the files below.

• ONLINE REGISTRATION (LINK)
• REGISTRATION FORM (PDF)
• MEDICAL & DENTAL HEALTH FORM (PDF)
• HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT (HIPAA) (PDF)
• NOTICE OF PRIVACY PRACTICES (PDF)

If you’re transferring from another dental office, please bring your previous dental records and radiographs (x-rays). Or you can request that your records be mailed to Fiant Dental by providing your previous dental office with this record transfer request.

• TRANSFER OF DENTAL RECORDS FORM (PDF)

Complete this application if you’re interested in 90-day no-interest financing options for your dental care.

• CARECREDIT® APPLICATION (ONLINE)