Patient Forms

Complete your paperwork before you arrive and spend less time in the waiting room.

At New Image Advanced Dental, patient forms help streamline check-in and ensure accurate, up-to-date information for your care. Please review and complete all sections legibly, and bring your photo ID, insurance details, and a medication list to your appointment.

Do you have questions or need assistance with forms? Contact New Image Advanced Dental at 719-846-7387!

Available Forms

Complete this form if you are visiting our office for the first time.

New Patient Form

Provide your current medical history so our team can tailor your care to your needs.

Medical History Form

Provide your health information for wellness and med spa services.

Health Information Form

Review our HIPAA privacy notice before your appointment.

HIPAA Privacy Notice

Please review and complete the following consent form if your visit includes a blood draw.

Blood Draw Consent Form

Please review and complete the following consent form before your esthetician services appointment.

Esthetician Services Informed Consent

We recommend completing the appropriate forms before your appointment to save time during check-in.

Wellness & Med Spa Forms

Please review and complete the following consent form before your IV infusion appointment.

IV Infusion Informed Consent

Please review and complete the following consent form before your standard ozone, UV, or IV therapy appointment.

Standard Ozone/UV/IV Therapy Consent

Please review and complete the following consent form before your high dose ozone therapy appointment.

High Dose Ozone Therapy Consent

Please review and complete the following consent form before your massage therapy appointment.

Massage Therapy Informed Consent

Please review and complete the following consent form before your Botox appointment.

Botox Informed Consent & Aftercare

Please review and complete the following consent form before your Morpheus8 appointment.

Morpheus8 Client Consent Form

Please review and complete the following consent form before your Sculptra appointment.

Sculptra Aesthetic Informed Consent

Review post-op instructions for your Sculptra treatment.

Sculptra Post-Op Instructions

If you have any questions about your paperwork or what to bring, please call us at 719-846-7387. You can also request an appointment online and our team will reach out to guide you through the process. We serve patients from Trinidad, Walsenburg, Raton, and across Southern Colorado.

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What Our Patients Say About Their Experience

Sarah Johnson

Absolutely wonderful experience from start to finish! The staff was incredibly welcoming and made me feel right at home. Dr. Wilson took the time to explain every step of my treatment and I felt completely at ease. My smile has never looked better. I cannot recommend this practice enough!

Michael Torres

I had been putting off going to the dentist for years out of anxiety, but this team changed everything for me. They were patient, gentle, and truly caring. The office is beautiful and modern, and the technology they use is impressive. I actually look forward to my appointments now!

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