accessibility ACCESSIBILITY
Dunes Dental Associates, P.A.
H. Eugene Butler, III, D.M.D.
Creating Beautiful Smiles

Patient forms

We have made our patient forms available to you as links.  For your safety and convenience, we recommend printing and completing these forms in the comfort of your home.

Please remember to bring your completed forms with you for your first appointment.

Patient Forms

Health History

Office and Patient Communication

HIPAA Notice Of Privacy Practices

Request For Release Of Patient Records



This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.