Patient Forms
Alan P. Friedler DMD, PC looks forward to having you join our host of satisfied patients. Dr. Friedler has a schedule tailored for your convenience. To schedule an appointment, please call us at (203) 245-7575 - Madison, CT or at (203) 787-0520 - New Haven, CT. To request an appointment online, please use our convenient Online Appointment Request Form.
Once you have made your initial appointment, you can pre-register online by simply clicking on the links below. Please complete the forms and click on submit. Alternately, you may download the forms, print them, fill them out and bring them with you to your visit. Completing the forms prior to your visit will help to speed up the new patient registration process and get you in to see the doctor faster!
Interactive Forms:
Downloadable Forms:
Disclaimer: If you register, make an appointment or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.
Please note: It may take a few minutes to load the forms if you are using a dial-up Internet Connection. If you are unable to view the forms, you may need to download Adobe Acrobat free by clicking on the icon below.
