New Patient Forms – Avon Village Family Dentistry 860-678-1140

Please complete these digital forms before your first appointment.

Online Forms:

Patient Intake Form

Insurance Information

Medical History (Men)

Medical History (Women)

HIPAA Consent

Records Release

COVID Questionnaire

 

 

 

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  • Testimonials

    • Thank you, I am impressed with the personal, thorough and friendly level of care. And my teeth look great!
      Laura P.
    • This is a great dental office where everyone is polite and professional. I developed a tooth problem and they were able to see me the day after I called for an appointment. I have had a root canal and two crowns.
      James A.
    • I travel from Vermont to get the best of everything. I love my dentist and the office.
      Kathleen C.

  • Company Profile

    Dr. Mentasti, Dr. Weston, and Dr. Sagalyn are committed to the dental health of you and your family. Come in and see why they are one of the most respected dental practices in Connecticut.