Peak Family Dentistry
Our office has moved to:
52 Summit Avenue
Hackensack, NJ, 07601

Patient Forms

Take a few minutes to download and fill out your forms on your time!

New Patient Forms

Includes:

General Info & Insurance Record
Health History Form
Dental History Form
HIPAA Forms
Financial Agreement Form

If you are having trouble filling these forms out at home or you would like to fill them out in person, please call our office and plan to arrive 30 minutes prior to your initial appointment.

Thank you!

Existing Patient Forms

Includes:

Health History Form
HIPAA Form
Financial Agreement Form

If you are having trouble filling these forms out at home or you would like to fill them out in person, please call our office and plan to arrive 15 minutes prior to your next appointment.

Thank you!

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If you have difficulty using our website, please email us or call us at (201) 487-4008
View the ADA Accessibility Statement