(585) 227-4190

543 Long Pond Rd, Rochester, NY 14612, USA

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©2016 by Lang Dental Group. 

For your convenience we have uploaded our new patient forms. Please print and complete the forms that best represent you or your child. We look forward to seeing you! 

New Patient Paperwork -  ADULT (ages 18 & OVER) 

*Click on PDF icon to left

New Patient Paperwork - TEEN (ages 13 - 17) 

*Click on PDF icon to left

New Patient Paperwork - CHILD (ages 12 & UNDER)  

(if child is age 6 or under, also complete the new

child questionnaire) 

*Click on PDF icon to left

Age 6 and under:

New Child Questionnaire 

*Click on PDF icon to left