BETTY D. KLEMENT, D.M.D.
Dentistry by Design
Creating beautiful smiles!

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

 

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require
Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

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

Before I went to Dr. Klement, I never smiled, because I was unhappy with my teeth or the way my smile looked. I knew I needed lots of dental work and was concerned about how it might feel. Dr. Klement was friendly, knowledgeable and put me at ease. Under her guidance, I had crowns, fillings and wisdom teeth removed all under oral sedation. I didn't feel anything and was totally relaxed. Everything turned out great. I get frequent compliments on my smile. It's really made a big difference in my life; I'm more outgoing and more confident.

N. Hardcastle

Recently when I had two crowns replaced, it was extremely important to me that they look as natural as possible. In fact, I had delayed having the dental work completed, because it was essential to me that it was done correctly. It was critical that I achieved a good end result. Dr. Klement and her team took the extra time to ensure that the procedure was done accurately and to my satisfaction. They valued my input on the cosmetic appearance of the dental work, and took the extra steps to bring about outstanding results. I am very pleased with the high standard of service that I received.

M. Morton-Williams

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