Patient Forms

Please fill out our online forms before your appointment:

•	Patient Screening Form
•	Medical History Form

Forms may also be downloaded to be filled out and returned:

•	HIPAA Notice of Privacy Practices (PDF)
•	HIPAA Designation of Personal Representative (PDF)

Neil L. Starr, DDS, PC

Washington Office

1234 19th St NW #306
Washington, DC 20036

(202) 293-7177

Neil L. Starr, DDS, PC, 1234 19th St NW #306, Washington, DC 20036 / (202) 293-7177 / starrteeth.com / 5/27/2023 / Related Phrases: dental implants DC /