Smart Dental Care
Emergency Dental
Care Available
1434 E 4500 S Ste 100
Holladay, UT 84117
801•272•8609
Call Us Map Us Email Us Emergency
Call Us Map Us Email Us Emergency
  • Home
  • About Us
    • Meet Dr. Ashton
    • Meet Dr. Nguyen
    • Meet the Team
    • Dental Technology
    • Blog
  • Services
    • General Dentistry
      • Family Dentistry
      • Sedation Dentistry
    • Cosmetic Dentistry
      • Veneers
      • Clear Aligners
      • Teeth Whitening
      • Dental Implants
      • Crowns
      • Dentures
    • Emergency Dentistry
      • Extractions
      • Wisdom Teeth Extractions
      • Root Canals
    • Restorative Dentistry
    • Sleep Apnea
    • Laser Dentistry
  • Showcase
    • Patient Testimonials
  • Patient Info
    • Patient Forms
    • Financial Policy
    • Educational Videos
  • Contact Us
  • What You’ll Learn
  • Contact Us
  • Home
  • Patient Forms

Patient Forms

Click the links below to download our Patient Forms

New Patient Forms

Medical History

Patient Screening Form

Financial Agreement

HIPPA Notice of Privacy Practices

1434 E 4500 S Ste 100
Holladay, UT 84117
801-272-8609
Contact Us
Contact Us
Full Name
0 of 500 max characters
  • Smart Dental Care
    • Home
    • Meet Dr. Ashton
    • Meet Dr. Nguyen
    • Meet the Team
    • Dental Technology
    • Contact Us
  • Services
    • Cosmetic Dentistry
    • Family Dentistry
    • Clear Aligners in the Holladay Area
    • Crowns
    • Dental Implants
    • Dentures
    • Emergency Dentistry
    • Extractions
    • Root Canals
    • Relaxing Sedation Dentistry in Holladay, UT
    • Sleep Apnea Treatment in Holladay
    • Veneers
    • Professional Teeth Whitening in Holladay, UT
  • Patient Resources
    • Patient Testimonials
    • Patient Forms
    • Financial Policy
    • HIPAA Patient Privacy Practices
    • Privacy Policy
    • Accessibility
Smart Dental Care © 2026 | Propelled by DentalCMO
NagiosCheckValue - Do not remove please