New Patient Registration Form
If you’re a new patient, welcome to our practice! Below, you’ll find our new patient registration form to get you started with your account. You can submit your completed form online or this form is also available in our office and can be completed during your visit.
Patient Registration Form
Choose this form for new patients registering for dental service.
Email us with Questions
info@DrGalaif.com
Our office staff will be happy to answer any questions you may have about the registration process. Feel free to call or email us any time at (818) 789-6789.