Crescent Family Dentistry
   
David A. Lester, DDS, PC
Services About Us FAQ Patient Information Financing Contact Us
David A. Lester, DDS, PC
  Patient Information
 

Welcome to our office and thank you for choosing our practice!  We look forward to meeting you.  We know you’ll enjoy Dr. Lester and our family oriented care. We have created our registration forms so they are easily accessible to you. Your computer must be equipped with Acrobat Reader to access the forms.

If you do not have Acrobat Reader, click here for a free download.

 
 

Please complete and submit the forms below before your appointment. Your signature will be signed in person in our office. You may want to print a copy for your records.

 
Patient Registration (Download PDF)
Medical History (2-sided) (Download PDF)
Payment Policy Acknowledgement (Download PDF)
Acknowledgement of Receipt of Notice of Privacy Practices (Download PDF)
     
Notice of Privacy Practices (Download PDF)

(You do not have to return the actual Notice of Privacy Practices.)

 

  Please be sure to call us 48-hours in advance if you are unable to keep an appointment as this notice makes it possible to give your appointment time to another patient who desires to see the doctor.  We reserve the right to charge a broken appointment fee or not reschedule missed appointments with less than a 48-hour reschedule notice.  We have voice mail available 24 hours a day, 7 days a week for your convenience.

We try to see all patients on an appointment basis and request that you call in advance so we can reserve time for you.  Our office telephone number is (541) 686-9372.  We make every effort to honor all time commitments and request that you extend the same courtesy to us.  If you have any questions, please don’t hesitate to call.

Sincerely,
David A. Lester, DDS, PC & Staff