Welcome to Petrucco Dentistry
Thank you for selecting our dental healthcare team! We will strive to provide you with the best possible dental care. To help us meet all your dental healthcare needs, please fill out this patient intake form (estimated time to do so: 10-15 minutes). All sections must be completed and submitted together at the end, as it cannot be saved and revisited at a later time. A separate COVID-19 wellness form will be collected prior to your scheduled appointment. If you have any questions or need assistance, please ask us- we will be happy to help.
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This form was created inside of Petrucco Dentistry PLLC.