(617) 207-8667
Dmitry G. Merzon D.M.D. • Request an Appointment

New Patients

 

Dedicated to building a trusting relationship that patients can count on for many years to come

We are committed to making your appointments as easy and comfortable as possible. Every new patient is asked to fill out a comprehensive medical and dental health history form. Dr. Merzon uses these forms to carefully evaluate every patient individually, to allow for thorough diagnosis and treatment planning, if necessary.

Please fill out the following patient forms before your visit:

  • New Patient Information Form
  • Medical and Dental Health History Form
  • HIPAA Notice of Privacy Practices Form
  • Consent for Services and Financial Policy

In attempt to save your valuable time during your first visit, these forms are available on-line.

Dental exam room - new patients

There are two options for your convenience:

 

online forms

Please click here to fill out New Patient Information and Medical History forms online. Enter you first and last name, and appointment date. If you do not know your appointment date simply enter tomorrow’s date. These forms will be sent to our office electronically, there is no need to print them.

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fill out at the office

As an alternative, you can always complete all of the forms at our office. In this case we kindly ask you to arrive 20 minutes before your scheduled appointment, in order to leave enough time to fill out the forms.

No Insurance? We’ve Got You Covered

Dr. Dmitry Merzon with a patient

If you don’t have insurance, we can help. We want our patients to have access to excellent dental care. We now offer the First Impression Dental Membership Plan. When you signing up with our plan, you receive financial options to help you care for your oral health.

Learn more and get started!

Schedule Your Appointment Today!