Dr. Alison Jones 913.491.0077 Overland Park, KS Dentist
  • Home
  • About Us
  • Services
    • Preventative Services >
      • Comprehensive Exam
      • Recall/Periodic Exam
      • Limited Exam
      • X-Rays
      • Intraoral Camera
      • Oral Cancer Screening
      • Dental Cleaning >
        • Adults
        • Children
    • Restorative Treatment >
      • Fillings
      • Crowns
      • Bridge
      • Implant Restoration
      • Full/Partial Denture
    • Night Guard/Sport Mouth Guard
    • Cosmetic Dentistry
    • Products
    • Dental Anxiety
  • New Patient
    • Patient Forms >
      • TMJ Exercises
  • Pay My Bill
  • FAQ's
    • Frequently Asked Questions
    • Smile Advantage
    • Tooth Whitening
    • Insurance Benefits
    • Finance Options
    • Holiday Hours
  • Contact Us
    • Directions to Our Office

Patient Forms

We appreciate you taking a moment to print and fill out the new patient forms below.  Please bring completed documents to your appointment.  We know it is a lot of information, but this helps us better assist you in a timely matter.  We look forward to seeing you!
Health History
Financial Policy
Dental History
Information Release
HIPAA Form
The Notice of Privacy Practices is available in our office.  Please be sure to see the Front Desk to obtain your copy.
Records Release
For patients wanting records/x-rays transferred from another office, please print and send in the Release form.

If you are unable to print forms, please arrive at least 15 minutes early to fill them out before your appointment.
  If you have trouble opening or printing any of the above documents, please call us at 913.491.0077.  Thank you.

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  • Home
  • About Us
  • Services
    • Preventative Services >
      • Comprehensive Exam
      • Recall/Periodic Exam
      • Limited Exam
      • X-Rays
      • Intraoral Camera
      • Oral Cancer Screening
      • Dental Cleaning >
        • Adults
        • Children
    • Restorative Treatment >
      • Fillings
      • Crowns
      • Bridge
      • Implant Restoration
      • Full/Partial Denture
    • Night Guard/Sport Mouth Guard
    • Cosmetic Dentistry
    • Products
    • Dental Anxiety
  • New Patient
    • Patient Forms >
      • TMJ Exercises
  • Pay My Bill
  • FAQ's
    • Frequently Asked Questions
    • Smile Advantage
    • Tooth Whitening
    • Insurance Benefits
    • Finance Options
    • Holiday Hours
  • Contact Us
    • Directions to Our Office