New Patient Forms

We recommend that all new patients arrive 15-20 minutes early for their first appointments. This will give you plenty of time to fill out a few simple new patient forms for our records and so that we may submit all necessary billing information to your insurance company, as well. At this time you will also be asked to read and sign our notice of patient privacy, which will acknowledge that you understand your rights as a patient at Jeffery A. Spilman DDS.

Want to save time waiting? Why not fill out your forms before you come? Simply download the forms below, print them out, complete them, and bring them to your visit. If you don’t have Adobe Reader on your computer, you will need to download it to access the forms.

If you have any questions about our new patient forms or what you will need to bring with you to your first appointment with Dr. Spilman, please feel free to call our St. Petersburg, FL office at 727-645-4727 or contact us using our online form.

Insurance Financial Policy

Patient Health History