Coal Creek Oral Surgery and Dental Implant Center

Patient Information

Our forms are available online so you don't have to spend extra time filling them out in our office. Fill them out at your convenience and then bring them with you to your appointment. If you choose to fill them out in the office, please arrive 15 minutes early so you have time to complete them.

If you have any questions, don't hesitate to give us a call! 

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. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Your First Visit

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed the same day as the consultation. However, a complex medical history or treatment plan may require an evaluation and a second appointment to provide treatment on another day.

Please assist us by providing the following information at the time of your consultation:

  • Your surgical referral slip and any x-rays if applicable.
  • A list of medications you are presently taking.
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: All patients under the age of 18 must be accompanied by a parent or guardian at the consultation visit.

A preoperative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink eight hours prior to your surgery. You will also need an adult to drive you home.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medications (i.e., heart medications, aspirin, anticoagulant therapy, etc.).

Pre-registration for your appointment is necessary for our office to better prepare for your visit.  You may register by clicking the Online Registration Form button above. If you do not wish to complete the registration online, please arrive a full 30 minutes prior to your scheduled appointment time.

X-Rays

If your dentist or physician has taken x-rays, you may request that they forward them to our office at [email protected] If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.

New Patient Forms and Post Procedure Information:

Before Intravenous Anesthesia Sedation

After Placement of Dental Implants

After Wisdom Tooth Removal

After Exposure of an Impacted Tooth

After the Removal of Multiple Teeth

After Tooth Extraction

Notice of Privacy Practices

Online Referral Form

Financial Policies

ADA Accessibility Statement

Have Questions? Get in Touch