Patient Forms

New PatientPACKET

Please take a moment to fill out our new patient packet. If you have questions, or concerns please feel free to call us at 775-827-5511.

Other Forms

Update Health History
You should update your medical history once a year, or when anything new has changed.
Medical History Update
Disclosures to Family member
If you like us to disclose any information about your chart, or billing. Please fill this form out so we can meet all HIPPA requirements.
Disclosure Form
X-ray Request Form
Please note we send our x-rays via email in most cases, and ask for 24 business hours. On 3D cone images they can only be mailed due to the size of the image.
X-ray Release Form
New Insurance
Please update your dental insurance information anytime your policy has changed. Note: Insurance is the patients responsibility to know and update, and is a courtesy that we bill.
Insurance Form

Do you have Questions?

You can call our front desk at 1-775-827-5511 Mon, Tue, Thur 8am – 5pm, Wed 8am-3:30pm, Fri 8am-12pm email us at homanfardental@gmail.com or fill the Contact Form