Patient Registration

Thank you for choosing Selznick Oral Surgery and Dr. Selznick for your Oral Surgery needs. You may complete registration ahead of time by downloading and printing our patient registration forms. Once the forms are completed, please bring them with you to your appointment.

Patient RegistrationPatient Health QuestionnaireConsent for Anesthesia and Extraction of TeethInformed ConsentPrivacy PolicyCOVID-19 FormFinancial AgreementMissed / Cancellation AgreementPharmacy Information

Looking For An Excellent Oral Surgeon?

Dr. Selznick limits his practice to wisdom teeth removal and dental extractions to provide you with competitive prices. Contact us today to schedule an appointment!
Call us: 702-436-9090