Patient Forms
Medical History & Financial Forms :
To better assist you in understanding your insurance please bring your medical and dental information on your first visit to us. Kindly download, print and complete the below forms, for submission upon your office visit. ALL FORMS MUST BE COMPLETED!
The below documents are PDFs (requires free Acrobat Reader 
)
Patient Medical History Form - Side 1
Patient Medical History Form - Side 2
PMP Form
HIPPA Form
Covid-19 Risk Form
Call us if you have any questions or concerns. Make an appointment with us today!
We focus on highly personalized care, from your first contact with our office, right through your last post-operative visit.
Should a dental emergency occur, we make every effort to see and care for you as soon as possible.
Dr. Kaplan's office is located in Providence, Rhode Island.
149 Governor St. Providence, RI.
(401) 861-5100