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Patient Forms
Man with computerThe following forms are provided to our patients. Please complete the forms before your appointment.

Financial Policy

HIPAA Form

Medical History

New Patient Form

If you have questions about any of the paperwork, please give us a call at (913) 268-9300 and our staff will be happy to help you.
Fay Periodontal Associates in Shawnee, KS
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Fay Periodontics, 6333 Long Ave., Suite 201, Shawnee, KS 66216-2544 • (913) 268-9300 • shawnee.annfayperiodontics.com • 3/6/2023 • Page Terms:periodontist Shawnee KS •