Forms

Registration

If you are a new patient to our office there we will need you to fill out our new patient registration form. You can complete the form online or print the form and fill it out before you come. This will help us expedite your check-in process.

Online New Patient Registration Form

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Printable New Patient Registration Form

Annual Medical History Update

Annual Medical History Update

Request An Appointment

We understand that there are times when you must miss an appointment due to emergencies or obligations for work or family. However, when you do not call to cancel an appointment, you may be preventing another patient from getting much-needed treatment. If an appointment is not canceled at least 48 hours in advance you will be charged a fifty dollar ($50) fee; this will not be covered by your insurance company.

Testimonials

  • "My teeth have had a rough life, but Dr. L and his whole team helped me keep my mouth healthy. I had 3 front teeth begin chipping."
    Anonymous 2019-04-05
  • "I definitely recommend!!"
    Bianca Marc 2019-04-06
  • "Dr. Lernor wants the best for his patients and gives honest options and assessments."
    verified patient of Dr. Eric W Lernor 2019-04-22
  • "Dr. Lernor and staff are wonderful."
    Janice F. 2019-05-03
  • "Extraordinary care - great team, thorough exam. Would recommend highly. Rudy in Scottsdale"
    Rudy in Scottsdale, AZ 2019-06-28
  • "I would like to say that Dr. Lernor is an excellent and high professional dentist. Dental Assistant is excellent and Hygienist is wonderful!"
    Ludmila Brigadier 2019-10-04
  • "Gentle care coupled with very informative and helpful staff"
    Mary C 2019-10-31
  • "Dr. Lernor and staff are always nice and go out of their way to do a great job."
    Anonymous 2019-11-03
  • "I always enjoy our conversations and our laughter. Every time I have a procedure, Dr. Lernor calls me that evening to see how I am doing."
    Anonymous 2019-11-04
  • "I have referred others to him and they have been pleased with his care as well."
    Tara Nolan 2019-11-05