Patient Forms

Please fill out our online forms before your appointment:

•	Patient Screening Form
•	Medical History Form

Forms may also be downloaded to be filled out and returned:

•	HIPAA Notice of Privacy Practices (PDF)
•	HIPAA Designation of Personal Representative (PDF)

Neil L. Starr, DDS, PC

Washington Office

1234 19th St NW #306
Washington, DC 20036

Neil L. Starr, DDS, PC, 1234 19th St NW #306, Washington, DC 20036 + (202) 293-7177 + starrteeth.com + 9/24/2023 + Page Phrases: dental implants DC +