Forms

Your First Visit With Our Orange Park Dentist - Resources and Forms

The first visit to our office is designed to get you better acquainted with all we offer as well as introduce you
to Dr. Klement and our caring staff. We encourage questions and do our best to always deliver quality care.

Please take a moment prior to your scheduled appointment to download our patient forms. We ask that you complete the forms and bring them with you to your appointment so we may better assist you in a timely manner. Thank you for your confidence in our office, we look forward to assisting you with all your dental needs.

PRACTICE PHILOSOPHY

PATIENT REGISTRATION

DENTAL HISTORY

HEALTH HISTORY

HIPPA FORM

SIGNATURE FORM

 


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Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.
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Testimonials

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Betty D. Klement, DMD
Phone: (904) 272-7277
2140 Kingsley Ave #4
Orange Park, FL 32073