Patient Forms

Patient Registration


New patients are welcome to complete their registration prior to your visit using our secure online Registration Form. Once the form has been completed, please be sure to press the Submit button to automatically send us your information. When you arrive for your appointment, we will have your paperwork printed and ready for you to sign. Please be assured that every precaution has been taken to ensure that our patients’ private health information remains secure.


Online Patient Registration
If you are a new patient please complete the online registration forms above. We ask for all patients to arrive 15 minutes prior to your appointment.

HIPAA Privacy Form


Please click on the link below to download our HIPAA Privacy form. Please print and complete the forms prior to your appointment. Please be sure to bring the completed form to your appointment, along with your insurance card. If you are unable to print the forms, please plan to arrive early for your appointment so that you can complete it in our office.


HIPAA Privacy Form

Medical Clearance Form


Please click on the link below to download our Medical Clearance form. If one of our oral surgeons requests that you obtain a Medical Clearance, then the completed Medical Clearance form is needed FROM YOUR PHYSICIAN BEFORE your DATE OF SURGERY. Please print the form and have your physician complete the forms and then fax them back to our office. All the necessary information is located on the form. If you are unable to print the form, please direct your physician to our website at warrenoralsurgery.com and click on Surgical Forms.


Medical Clearance Form