Patient Registration and Forms
THANK YOU IN ADVANCE for supplying the information which will assist us in
updating our computer software's data in an efficient and accurate fashion.
The link at the bottom of this page will take you to Dr. Teen's "Patient Registration Site", which is a "Secure" website connecting directly to our dental software provider's data base.
( RE "Patient Consent" notice - Insurance benefits will not be assigned directly to us, except in special situations.)
Please fill out your information as accurately as possible (you need not enter driver license info).
IF you have dental insurance, please try to fill in ALL FIELDS in related sections.
To Submit all of your information after you have entered it, scroll to bottom of the page and click the "Confirm Registration" box.
A Note for Dr. Teen's Existing Patients: IF you are an existing patient seeking to update your information, select the "Existing Patient" button instead of the "New Patient" button when you arrive .
updating our computer software's data in an efficient and accurate fashion.
The link at the bottom of this page will take you to Dr. Teen's "Patient Registration Site", which is a "Secure" website connecting directly to our dental software provider's data base.
( RE "Patient Consent" notice - Insurance benefits will not be assigned directly to us, except in special situations.)
Please fill out your information as accurately as possible (you need not enter driver license info).
IF you have dental insurance, please try to fill in ALL FIELDS in related sections.
To Submit all of your information after you have entered it, scroll to bottom of the page and click the "Confirm Registration" box.
A Note for Dr. Teen's Existing Patients: IF you are an existing patient seeking to update your information, select the "Existing Patient" button instead of the "New Patient" button when you arrive .