980 E. 12th Street

Brooklyn, NY 11230

Call Us Today!

Book Appointment

New Patient Information

DSC_9217 DSC_9259A patient’s initial dental consultation is an important step in establishing a good patient-doctor relationship. During your initial visit, we will obtain both dental and medical records, and provide you sufficient, quality time to consult with your dentist.

Upon review of your records, we assess your dental health. The dentist will take photos of your teeth and decide if you will need dental treatment. Additionally, our friendly medical staff is here to assist you with any questions or concerns you may have.

To view and print the medical history and privacy policy forms, Adobe Acrobat Reader needs to be installed in your system.

Patient History Form
HIPPA Form

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Mission Statement

Our mission is to provide our patients with quality preventative dental care aimed to promote healthy teeth and gums. We are committed to:

  • Providing a staff that is attentive, polite and sensitive to your dental needs
  • Providing innovative treatment options and procedures for our patients
  • Going beyond standard service and striving to exceed our patients’ expectations
  • Safe, comfortable environment

Patient Dental Forms

A patient’s initial dental consultation is an important step in establishing a good patient-doctor relationship. During your initial visit, we will obtain both dental and medical records, and provide you sufficient, quality time to consult with your dentist.

Upon review of your records, we evaluate your dental health. The doctor will take photos of your teeth and decide if you will need dental treatment. Additionally, our friendly medical staff is here to assist you with any questions or concerns you may have.

Patient Dental Forms

Prior to your first consultation, we advise patients to fill out the Privacy Policy and Medical History forms. We recommend filling out the forms prior to coming into the office in order to speed up the process. Upon arrival of your appointment, please submit your forms to our staff.

Directions and Parking

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980 E. 12th Street

Brooklyn, NY 11230

Call Us Today!

(718) 377-3222

Book Appointment

info@EmpireDentalNY.com