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New Patient Forms

(New Forms Coming Soon!)

 

   
 

 

Please download, print and fill out the forms.

 

  Patient Information

  Medical History

 Financial Agreement

  Notice of Privacy Practices 

  Receipt of Notice

 

Thanks and looking forward to meeting you.

 

Dr. Paul Burton & Staff


 

    Copyright©2011-2024. All rights reserved. Paul Burton D.D.S.

 

 Copyright©2011-2020. All rights reserved. Paul Burton D.D.S. | 8116 Cantrell, Suite C, Little Rock, AR | Phone 501-227-5200 |