Patient Forms
To view the forms listed below, you will need Adobe Reader. Please bring your completed forms with you to our office at the time of your visit. If you are an existing patient and wish to create a patient portal account, click here and fill out this online form.
Practice Forms
- Dr. Bottoms Adult Background Form
- New Patient Consult Packet
- Medical Record Request
- Patient Privacy Notice
- Patient Rights & Responsibilities
- New Patient Headache Packet
- New Patient Tinnitus Packet
- New Patient Dizziness Packet
- New Patient Psychiatry Packet
- New Patient Pain Management Packet
- New Patient Doppler Packet
- New Patient Infusion Packet
- New Patient Packet Consult Packet ECT-TMS
- Forms Completion Request
MyDENTChart
MyDENTChart gives you easy and convenient 24/7 access to your medical information and team from the comfort of your own home or office.
Using our secure portal you will be able to:
- View your medical and account history
- Communicate with our providers
- Review Test Results
Getting Started
We would be delighted to get you started, please click on the link below titled “MyDENTChart” or call or email us:
MyDENTChart
Telephone (716) 558-3535
MyDENTChart@dentinstitute.com
Although this tool is designed to be a convenient resource for our patients, it should not take the place of any important communication about your care. We continue to encourage you to call our office as necessary.