Patient Forms

Thank you for choosing Jax Multispecialty Dental Center for your dental needs. We are confident that you will be very satisfied with the services that we offer. We know you have choices and we feel honored you have selected us among other specialist.

Please bring a copy of your driver’s license/ ID card and, if it applies, both your dental and medical insurance cards. Some of the services we provide are often covered by medical insurance. This allows your dental insurance benefits to go farther, which can reduce your out of pocket expense.

We do ask that you have your paperwork completed prior to your appointment time so please print the attached papers and fill out all your information needed. If it is not possible for you to complete your paperwork online please arrive to your appointment 15-20 minutes early. If you have questions, please contact us.

If for any reason you are unable to keep this appointment, please call us as soon as possible at 904-786-9200 to reschedule. This will allow us to offer the appointment time to another family or patient and avoid a broken appointment fee.

Again, thank you for choosing Jax Multispecialty Dental Center.