Patient Forms

We want your visit at Valley Dental Group to be a great experience. Our prosthodontist and team put the focus on you and your smile, and we want you to be able to spend as much time as possible with Dr. George Eifler. By completing your paperwork prior to your dental appointment in Phoenix, Arizona, you will do more than streamline your visit. You will also give us the chance to learn more about you and your goals for your smile. We can also discuss any underlying medical conditions that may affect your dental care, including any medications you are taking. And it just gives us the opportunity to get to know one another. We value our patients as people and always strive to go above and beyond when it comes to caring for you.

Records Release Authorization

Medical History

Patient Form

2nd Patient Form

Patient Screening Questionnaire

Questions Form

Patient Consent Form

Detailed Patient Form

Notice of Privacy Practices

Medical History

Referral Sheet for DDS

Downloadable Forms
Records Release Authorization

If you need assistance with your forms or are ready to schedule your appointment, call our office at 602-956-2260. One of our team members will be happy to help.