Patient Forms

If you are a new patient to Bivona Family Dentistry, the forms below will need to be filled out when you arrive for your first appointment in office. You must print forms to bring with you into the office. Filling them out ahead of time will allow us to attend to your dental needs more quickly than completing them on your arrival. Thank you and please call our office if you have any questions or need any assistance.


We do not “double book” appointments. When we schedule with you, Dr. Bivona’s and Dr. Ansley’s time is reserved specifically for you. Cancellations often leave this time unused, making it difficult for us to accommodate other patients.

We request a minimum of a 4-hour notice for cancellations or changes to your appointment to avoid a $50 missed appointment fee. We appreciate your cooperation and understanding.