New Patient Information

At Dr Sam Romano, your first appointment includes a thorough exam and gathering any information that our dentist must be aware of in order to provide care specifically to your oral health. We understand that all patients are different and require individualized care. 

To facilitate being seen as soon as possible at the time of your appointment, please download and complete the following forms. Please assist us by providing the following information at the time of your consultation:

  • A list of your current medical prescriptions
  • X-rays: If your previous dentist has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at the practice.
  • If you have dental insurance, bring your insurance card.

Our office is also experienced with obtaining certain benefits from your traditional medical insurance plans. Many of our surgical procedures, TMD treatment, Sleep Apnea Appliances and sedation procedures are often covered.

Download New Patient Form


Download HIPAA Privacy Form


Download Financial & Appointment Policy Form


Post-Procedure Factsheets

For all our current patients who have to, or have recently had any procedures check out the various fact sheets we have put together for you. These are for your follow-up and home care.



Insurance Accepted - ask us for which providers we accept.





We finance through Care Credit, ask us how






What Every Patient Can Expect

At our practice, every patient can expect to be treated with prompt service at their specified appointment time. Our patients can also look forward to a comfortable experience. We understand that visiting a new dentist can be stressful, which is why our practice works actively to accommodate all patients and alleviate any fears they may have about a new dentist or dentistry treatments. Familiarizing yourself with our practice, services, and our dentist is a great first step to creating a long term and comfortable experience with dentistry.