Patient Forms

These Patient Information and Health History forms are provided for your convenience to print out and complete at home in advance.

Completing these forms at home can not only save you a lot of time but it helps us to stay on time (for you and others). There is nothing more frustrating for all of us than a patient who arrives late for their appointment, then uses the remaining time reserved for their care to complete information and history forms.

For patients who are on multiple medications, unless you carry the exact names of your meds with you (which you should do anyway in case of emergency), misspellings can create confusion as to exactly what medication you are taking.

(These forms are .pdf files):

Wisdom Tooth Removal Report

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Theodore J. Grellner, DDS, PA

Palm Lake Office Building

(813) 972-3478

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