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Patient Forms


Woman with computerThe following forms are provided to our patients. Please complete the forms before your appointment.

Financial Policy

HIPAA Form

Medical History

New Patient Form

If you have questions about any of the paperwork, please give us a call at one of our two locations, and our staff will be happy to help you.
Copyright © 2020-2021 Fay Periodontics and WEO Media (Touchpoint Communications LLC). All rights reserved.  Sitemap | Links
Fay Periodontics, 207 East 63rd Street, Kansas City, MO 64113; (816) 673-2230; annfayperiodontics.com; 11/5/2021; Associated Words: Periodontist Kansas City MO; Periodontist Kansas City MO;