Michael R. Everett
3120 Fireline Rd.
Palmerton, PA 18071
Michael R Everett DDS PC

Patient Forms

For your convenience, we have provided PDF versions of forms for new patients. Before your first visit, please print and fill out the below forms and bring them in on your first visit. This will insure getting you in in a timely manner. Also, please remember to bring in your insurance information, if any, during your first visit.

Your initial exam will be comprehesive as we establish a baseline of your current dental health. Photographs, models and records of your teeth and gum, along with radiographs will be gathered. We will then be able to review and address your many options and answer any questions. We look forward to serving your needs and wants.
Michael R Everett DDS PC - 610-826-2001

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3120 Fireline Rd. - Palmerton PA 18071