New Patient Forms

Please print all forms below and bring them completed, along with your insurance card, to your first visit. We look forward to seeing you!

Permission Wallingford

Patient Information

Children's Health History Form

Adult Health History Form

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Contact Information

Wallingford Dental Associates

205 N. Main St.
Wallingford, CT 06492

Phone: 203-265-1250

Business Hours:
Monday: 7 a.m.-5:30 p.m.
Tuesday: 7 a.m.-7 p.m.
Wednesday: 7 a.m.-5:30 p.m.
Thursday: 7 a.m.-5:30 p.m.
Friday and Saturday: 7 a.m.-noon

We accept Visa. We accept MasterCard. We accept American Express.
We accept Discover. We accept CareCredit.

click here to download new patient forms