New Patients Form – Medical & Dental History

New Patients Form | Medical & Dental History

New Patients Form – Medical & Dental History

What to Expect

Your first appointment with Dr. Westersund could be the first step to life lasting dental health.
After booking an appointment, we will:

  • introduce you to one of our consultants to discuss your needs or treatment
  • take you on a tour around the office
  • take digital photographs and radiographs
  • perform a thorough exam by Dr. Westersund
  • discuss any treatment options
  • provide you with an overview of cost


We would like to give you the best possible care, but … then we need to know more about you! Detailed information about your current health, habits and requirements (or medication) will provide us with clarity which avoids misinterpretation. Rest assured, all your information is safe with us and strictly confidential.

You may choose to complete our medical/dental form below now – or – at our office.
Take action today – you’re welcome!

Please complete Medical History and Personal Information Forms prior to your New Patient Appointment.


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