Patient Information

What We Need From You

At Brockport Dental, 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. 

New Patient Form


Health History Form


Insurance Release Form


Hipaa Privacy Policy Form





Insurance Accepted - We accept all insurances, ask us which insurance providers we are in network with.






We offer In-Office Financing as well as Care Credit, ask us how

Call our office for more details 585-636-0555.







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.

Treatment you can trust, consistent excellence

We make it our goal to provide you with consistently superior dental care, specifically tailored to your needs. Because we take pride in what we do, we will stand behind our work at each step of your treatment, and value your opinion.