Washington DC Dentist Office Patient Forms

Dr. Nishan Halim is your neighborhood dentist in Washington, DC. Our practice brings modern dentistry solutions to the Capital Hill area. To ensure your first appointment goes as smoothly as possible, please review and fill out these patient forms before visiting our office. If you have any questions or are having trouble accessing these forms, feel free to contact our office directly for more information.

Medical History Form

As required by law, our office adheres to written policies and procedures to protect the privacy of information about you that we create, receive, or maintain. Your answers are for our records only and will be kept confidential subject to applicable laws. Please note that you will be asked some questions about your responses to this questionnaire and there may be additional questions concerning your health. This information is vital to allow us to provide appropriate care for you.

Notice of Privacy Form

This notice describes how health information about you may be used, disclosed, and how you can access this information. Please review it carefully and sign the acknowledgment form.

Financial Agreement Form

At Nishan Halim DMD, we endeavor to maximize your dental benefits and make your treatment fees as affordable as possible. We strive to limit the cost of treatment as a deterrent in accepting the quality care you need or desire.

Records Release Authorization

This form is necessary to authorize the release of your dental records and x-rays to the office of Dr. Nishan Halim.