
As your Raleigh area North Carolina general dentists, we understand that your time is valuable. In order to streamline your visit, you can access all of our Riccobene Associates Family Dentistry patient forms online, complete them at your convenience prior to your appointment, and bring them in with you to the office.
If you would rather complete paperwork at our office, we ask that you arrive 15 minutes before your scheduled appointment, enjoy a complimentary beverage, and feel free to ask for our assistance with any questions you might have.
To download and fill out forms ahead of time:
- Click on the links below to open each form in a new tab.
- Click the “Download” button, or right-click and select “Save Page As” to save the form to your computer.
- Once downloaded, open up each PDF document in Adobe Reader. To complete the forms, click in each blue box and type your answer; then save the document when you are done and print it out. (You can also print the forms out first and write your answers.)
AUTHORIZATION TO SHARE HEALTH INFORMATION
APEX RECORDS RELEASE AUTHORIZATION
BENSON RECORDS RELEASE AUTHORIZATION
CARY RECORDS RELEASE AUTHORIZATION
CARY RECORDS RELEASE AUTHORIZATION – PEDIATRIC
CLAYTON RECORDS RELEASE AUTHORIZATION
DURHAM RECORDS RELEASE AUTHORIZATION
GARNER RECORDS RELEASE AUTHORIZATION
GARNER PEDIATRIC RECORDS RELEASE AUTHORIZATION
GOLDSBORO RECORDS RELEASE AUTHORIZATION
HOLLY RIDGE RECORDS RELEASE AUTHORIZATION
KNIGHTDALE RECORDS RELEASE AUTHORIZATION
MEBANE RECORDS RELEASE AUTHORIZATION
MONKEY JUNCTION RECORDS RELEASE AUTHORIZATION
PORTER NECK RECORDS RELEASE AUTHORIZATION
RALEIGH FALLS RECORDS RELEASE AUTHORIZATION
SELMA RECORDS RELEASE AUTHORIZATION
BENSON RECORDS RELEASE AUTHORIZATION
BENSON RECORDS RELEASE AUTHORIZATION