Patient Forms

The first visit to our Oakhurst, New Jersey office is designed to get you better acquainted with all we offer as well as introduce you to Dr. Elizabeth Fanciullo, Dr. Paul Santos, Dr. Robert Sacks, and our caring staff. We encourage questions and do our best to always deliver quality care.

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to assisting you with all your dental needs.

NOTE: Kindly provide us with 24 hour advance notice if appointment cancellation is unavoidable. Thank you.

Patient Forms – Click the form you want to print.

Adult Patient Registration

Child Patient Registration

HIPAA Privacy Act

HIPAA Acknowledgement