Dental Patient Registration
You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.
Online Patient Registration
Printable Registration Forms for New Patients
Please print and complete the forms below to bring with you to your First Visit to our office if you prefer to not submit online.
Printable Getting To Know You
Printable Whitening Forms
Your Teeth Deserve Superior Care
Dr. Birnbach offers a number of dental treatments that can keep your mouth healthy and your smile beautiful. Contact us today!