Patient Privacy Policy & Patient Forms
• We are fully compliant with HIPPA regulations. We value you privacy and have protocols in place to assure that your privacy is maintained.
Click Here to view or print Middletown office HIPPA form
Click Here to view or print Manahawkin office HIPPA form
• To help facilitate the registration process at Alliance Oral Surgery, we ask that new patients print out and complete Registration Packet Health History Form and bring it with them to the office.
Click Registration Packet Combined OMS2015 (1) to view or print New Patient Registration Packet Health History Form
• Please read Anesthesia Consent Form fully sign if your procedure calls for Anesthesia.
Click Anesthesia Consent for Manahawkin to view and print Alliance Anesthesia Consent Form.
• Instructions prior to surgery with Anesthesiologist.
Click Alliance Pre-op instructions to view and print instructions prior to surgery.