★★★★★ 4.9 Rated (184 Google Reviews)  •  Main Line Dental Arts • Specialized Periodontics & Dental Implants  •  Dr. Milita Borguet, DMD • Dr. Margaret Hodgson, DMD • Dr. Peter Susanin, DMD  •  Call (610) 664-9510  •  110 N Essex Ave, Narberth, PA 19072

Patient Forms

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Fast & Convenient

Complete Your Paperwork Ahead of Your Visit

To save time during your appointment, please download and complete our patient registration forms. You can print and bring them with you or email completed copies to Borguet@gmail.com.

New Patient Registration

Includes basic contact details, emergency contacts, primary dental insurance details, and primary general dentist contact info.

Download Packet (PDF)

Comprehensive Medical History

Details your medical health conditions, cardiovascular history, diabetes status, artificial joints, allergies, and prescription medications.

Download Medical Form (PDF)

HIPAA & Financial Acknowledgment

Notice of Privacy Practices safeguarding your protected health information (PHI) and agreement to our standard office billing terms.

Download HIPAA Form (PDF)

Prefer to Complete Forms in the Office?

No problem at all! If you prefer to fill out your forms in person, please arrive 15 minutes prior to your scheduled appointment time so our team can assist you.