Patient Forms Tampa

The Easiest Way to Save Time at the Dentist’s Office

We offer multiple patient forms for your convenience so that your session with Dr. Justin Elikofer, Dr. Rodney Holcombe, or Dr. Sara Sheffield goes as smoothly as possible. We offer new patient forms as well as medical history update forms, which we encourage you to fill out prior to your scheduled appointment if needed. We also have a sleep apnea questionnaire for you to fill out, in case you are wondering whether you should receive sleep apnea treatment. Our dentists and team are ready to serve you and to provide you with the high-quality dental care you deserve! Call Advanced Dental Associates at 813-972-9077 to schedule an appointment and learn more about our comprehensive dental services in Tampa, Florida!

Patient Information

If you are new to our practice, we will use our patient information form to collect your contact information, insurance information, important medical information and dental health records. Please fill out this form before your first visit to our office.

New Patient Information

Patient Information Update

If your insurance, contact information or medical history has changed, we will ask you to update that information with our patient information update form.

Patient Information Update

Photographic Authorization

Our photographic authorization form grants us permission to use videos or photos of our patients for advertising, marketing or social media.

Photographic Authorization

Medical Release Form

If you are a patient who is unable to return to work due to a dental injury or illness, our team can write a medical release form.

Medical Release