Secure Online Patient Portal

You may preregister with our office by filling out our secure online Patient Registration Form. 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.

Click below for the Waters Ave location Patient Portal registration and Medical History forms. 

Friendly Smiles Dental Waters New Patient Forms          waters_med_history

 

Click below for the Carrollwood location Patient Portal registration and Medical History forms. 

Friendly Smiles Dental Gunn Hwy New Patient Forms          gunn_med_hisstory

 

Click below for the Lutz location Patient Portal registration and Medical History forms. 

Friendly Smiles Lutz New Patient Forms          lutz_med_history

 

Click below for the Odessa location Patient Portal registration and Medical History forms.

odessa_new_forms          odessa_med_history