Hernando County's Periodontal Specialist
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Patient Information

Before Your Appointment

To help us be more efficient when you arrive for your first appointment, please download the forms below. Read each document, complete the information where required and sign. Bring the completed forms with you and arrive a few minutes prior to your appointment time. We look forward to helping you maintain your periodontal health and achieve your best smile! 
dental_history_inventory.docx
File Size: 890 kb
File Type: docx
Download File

hipaa_pages.docx
File Size: 45 kb
File Type: docx
Download File

new_patient_paperwork_pg_1.docx
File Size: 53 kb
File Type: docx
Download File

payment_policy.docx
File Size: 26 kb
File Type: docx
Download File

Call for More information
Picture
Periodontal Therapy Center
Dr Jeffrey Hameroff, DDS
Periodontist
7320 Forest Oaks Blvd.
Spring Hill, FL 34606
352.596.1771
​[email protected]
Copyright Periodontal Therapy Center 2018                                                                                                             Website by Sales Up Solutions, LLC
  • Home
  • Our Services
    • Periodontics
    • Extractions
    • Implants
    • I.V. Sedation
  • Our Team
    • Our Pledge
  • Connect With Us
  • Patient Information
  • Our Blog
  • Reviews