Online Patient Pre-registration

Pre-register for your Oral Surgery Appointment

person using a tabletTo help insure accuracy and save time, you can pre-register HERE online before arriving for your first appointment. The information, including your medical history is transferred to our secure servers using a HIPAA compliant protocol to protect your personal information.

You may also print out the registration form and medical history and fill it out beforehand, then bring it to the office on your first visit.

It is our goal to make the registration process as convenient as possible for you.

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.

Online Patient Registration

Looking For Excellent Oral Surgical Care?

Dr. De Tolla can treat a variety of problems related to the mouth, teeth, and face. Call us to learn more or to schedule an appointment.

Call us: 603-436-3608