Schedule Appointment: 205-221-5610
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Dental Patient Forms

We’ll need the information on the forms below prior to getting started. Please download the form, complete it and bring it to your first visit. If you are not able to complete these forms prior to your first visit, please arrive 10 minutes before your scheduled appointment.

The forms are PDFs and require you have Adobe Reader to open them. (Nearly all computers have this. If you cannot open the form, you can download it here: Adobe Reader.)

Patient Information

Patient Form

Medical History

Medical Form

Dental History

Dental Form

Insurance Information

Insurance Form
General and Implant Dentistry
Michael Jennings DMD
310 The Mall Way
Jasper, AL 35504

Phone: 205-221-5610

Office Hours:
Monday-Thursday: 7:00am - 5:00pm
Friday-Sunday: Closed
Schedule Appointment ›

Dental services

Cosmetic DentistryDental EmergenciesDental ImplantsDentures
Hybrid DenturesFixed BridgesGeneral DentistryPeriodonticsPorcelain VeneersRoot Canal TherapySame-Day CrownsSedation DentistryTeeth WhiteningTooth Extractions

Dental specials

Free Dental Implant Consultation
Dental Implant Special

Patient information

New Patient FormsFinancial Information

About us

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