Online Patient Registration
READ THESE IMPORTANT DIRECTIONS BEFORE PROCEEDING!!!
1. CLICK the button below and complete the entire form.
2. PRINT a copy of the form and bring the copy to your appointment.
3. Be sure to press the SUBMIT button before closing the browser.
By ELECTRONICALLY SUBMITTING your registration online and ahead of time you will see the doctor much faster. The average time saved is 35 minutes. Your visit will also be more efficient as our patient care coordinators will not have to type all your information into your electronic medical record manually. Typographical errors are also eliminated.
Your information is transferred into your HIPPA compliant and secured electronic medical record upon your arrival. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Remember to PRINT a copy to sign and then press SUBMIT!
After completing the patient registration form feel free to spend some time on our website to learn more about the NJ Center for Oral Surgery and their surgeons.
If you are coming to see us for either Wisdom Teeth or Dental Implants you should watch the online videos before your initial appointment. This will give you valuable information to discuss with your doctor as well as saving you about 15 minutes during your consultation visit. These online videos can be found under the Procedures tab above.