New Patient Forms

Please feel free to download our forms and send them in by mail or by fax for pre-registration and benefit verification for insurance.  The following three forms are necessary for pre-registration:

Pre-registration Forms In English:

1. New Patient Form
2. Acknowledgement of Receipt of Notice of Privacy Practices
3. Consent for Use and Disclosure of Health Information

Pre-registration Forms In Spanish:

1. Formulario Para Pacientes Nuevos 
2. Reconocimiento De Recibo De Notificacion De Practicas Privadas 
3. Consentimiento Para Uso y Revelacion De Informacion De Salud

Please include a copy of your insurance card (front and back) and mail or fax these forms to:

Berger Dental Group, P.A. 
Post Office Box 6705
Columbia, SC 29260
Fax: 803-738-0300

Additional Forms:

Post-Op Discharge Instructions
Extraction Post-Op Instructions
Instrucciones Post-Operativas Despues Del Despido 
Instrucciones Post-Operativas Despues De Una Extraccion