See photos, by award-winning nature photographer Lisa Densmore Ballard, in our waiting room.

Mascoma Dental Associates Patient Information

NEW PATIENTS

As part of your first visit with us, you will need to complete your patient information to include a comprehensive Medical and Dental History Form, a short HIPAA Acknowledgement of Receipt of Notice of Privacy Practices form, and a Payment Options Form. 

Please download PDFs of the forms by clicking on the links below, fill them out, and bring the signed forms to your first appointment.

Patient Medical History Form
Front and Back

Kids Medical History Form
Front and Back

Notice of Privacy Practices

Acknowledgement of Receipt of Notice of and Privacy Practices

Payment Options Form

_________________________________________

EXISTING PATIENTS

Existing patients can access their accounts online at the Patient Login link below.

Patient Login

 

Quality Dental Care With A Gentle Touch

Provided by

George Petrescu-Boboc, DDS

Mark W Governo, DMD

Archana Sharma, DMD

Lauren Andreolas, DMD

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