New Patient Forms

We are happy to offer our patient forms online. Please feel free to print and fill them out at your convenience before your visit.

New Patient Registration

Please download, print and complete this form before your first dental appointment.
Click here to download (66 KB)

Patient Agreement

Please download, print and complete this form before your first dental appointment.
Click here to download (93 KB)

Financial Responsibility

Please download, print and complete this form before your first dental appointment.
Click here to download (121 KB)

Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Click here to download (229 KB)

HIPAA Form

Please download, print and complete this form before your first dental appointment. This form confirms that you read our Notice of Privacy Practices.
Click here to download (295 KB)

 
If you are unable to view the pdf files, please click on the icon below to download and install Adobe Reader:

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    Tuesday
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    Afternoon
    Early Evening

Our Office

Robert A. Claypoole, DMD, PC

2800 E County Line Road
Hatboro, PA 19040
Map & Directions
 
Phone: (215) 675-6400
 

Office Hours*:
Monday9:00am-5:00pm
Tuesday 12:00pm-7:00pm
Thursday8:30am-5:00pm


*Emergency hours 24x7 Call us at (215) 429-0326 or (215) 801-4331 for immediate attention.