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 Complete and Send 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.

Patient Registration

COVID-19 Consent & Disclosure Form

Epworth Sleepiness Scale (English)

Epworth Sleepiness Scale (Spanish)

New Patient Forms

Feel free to print out the patient registration forms prior to your visit and bring them filled out to your appointment.

Sleep Apnea

Additional Patient Forms

Please print out these additional forms for patients with special needs prior to their visit and bring them filled out to the appointment.

Save Time By Pre-Registering

We are committed to providing the most advanced, compassionate, and convenient oral health services to our patients and their families in all of Roswell and Southeast New Mexico!

Roswell Office Appointments Map & Driving Directions