Patient Forms, Map and Directions to Soddy Daisy & Dunlap Offices
Your first visit to Jeffrey Brewer D.D.S. establishes a vital foundation for our relationship with you. Our staff will take the time needed to get to know you and listen to your dental concerns.
Below, you will find a list of forms that you will need to fill out. These can be printed directly from this page so you can fill them out and bring them to your appointment or you can arrive a few minutes prior to your appointment to complete them in office.
Also, there is a link provided at the bottom of this page containing driving directions to our Dunlap and Soddy Daisy offices. Pictures of our buildings are also provided to give you a visual of each office building.
Please print and fill out these forms so we can expedite your first visit:
- Patient Registration
- Medical History
- Patient Record of Disclosures
- Receipt of Notice of Privacy
- Financial Policy
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
Soddy Daisy Office