Referring Dentists
Facebook
Google+
LinkedIn
YouTube
Instagram
Pinterest
248-901-0000
prestine periodontics logo
Menu
  • ABOUT
    • TEAM
      • DR. SAYED
    • INITIAL VISIT
      • WHAT TO EXPECT
      • DIRECTIONS
      • CONTACT INFORMATION
      • OFFICE GALLERY
    • REVIEWS
      • “I never loved my smile. Until Dr. Sayed redesigned it. Now, I have what really could be called a Pristine smile.” —Sara S.

      • View More Reviews
    • Close
  • PERIODONTAL DISEASE
    • WHAT IS PERIO DISEASE?
      • CAUSES OF PERIO DISEASE
      • SYMPTOMS OF PERIO DISEASE
      • NON-SURGICAL TREATMENT
      • SURGICAL TREATMENT
    • WHO GETS PERIO DISEASE?
      • PREVENTION
      • RISK FACTORS
      • INFORMATIONAL VIDEOS
    • SYSTEMIC COMPLICATIONS
      • DIABETES
      • HEART DISEASE
      • OTHER DISEASES
    • Close
  • IMPLANTS
    • WHAT ARE IMPLANTS?
      • THE PROCESS
      • WHAT TO EXPECT
      • IMPLANT ADVANTAGES
      • IMPLANT FAQs
    • OPTIONS FOR MISSING TEETH
      • BONE REGENERATION
      • GUIDED BONE REGENERATION
      • SOCKET GRAFTING
    • IMPLANT CARE
    • Close
  • SERVICES
    • GUM RECESSION
      • ACELLULAR DERMAL MATRIX
      • LASER SURGERY
    • SMILE DESIGN
      • GINGIVECTOMY
      • FRENECTOMY
      • CROWN LENGTHENING
    • OTHER SERVICES
      • EXPOSURE OF IMPACTED TEETH
      • SINUS LIFTS
      • BONE GRAFTING
      • SOCKET GRAFTING
      • IV SEDATION
      • SCALING AND ROOT PLANING
      • OSSEOUS SURGERY
    • Close
  • GALLERY
      • IMPLANT GALLERIES
      • GUM RECESSION GALLERIES
      • PERIO TREATMENT GALLERIES
      • SMILE DESIGN GALLERIES
      • INFORMATIONAL VIDEOS
      • FACILITIES GALLERY
    • Close
  • NEWS
    • Seminar: Schedule
    • Motor City Study Club
    • TRIOS 3SHAPE
    • Close
  • FORMS
  • REFERRING DENTISTS
  • CONTACT

Patient Forms

The following PDF information forms are available to view and download:

  • Instructions for Periodontal Surgery
  • Instructions for Sinus Lift Surgery
  • Instructions for Soft Tissue Graft Surgery
  • Instructions for IV Sedation
  • Instructions for Post Scaling and Root Planning

These fillable PDF patient information forms are available to view and download:

  • Doctors Referral Form
  • Patient Registration Form
  • Dental History Form
  • Medical History Form
  • General Consent Form
  • XRAY Release Form

To view and fill out these forms on your computer, please download the latest version of Adobe Reader for free at www.Adobe.com. Save time and paper by filling out electronically and send direct to our front desk. Or print, fill out manually and bring to your next appointment. Call Pristine Periodontics and Implants at (248)-901-0000 to schedule your consultation.

The following periodontal patient education videos demonstrate the process of placing a dental implant and crown for patients considering these or other procedures. See more periodontal education videos in the Informational Video Gallery.

Patient Consent Implant Video Missing Teeth

Patient Consent Implant Video Missing Teeth

See more educational videos in our Informational Video Gallery.

CONTACT

2425 East Lincoln St., Suite 100
Birmingham, MI 48009

248-901-0000

248.901.0003

frontdesk@pristineperioimplants.com

HOURS

Monday: 8AM – 5PM
Tuesday: 7AM – 2PM
Wednesday: 1PM – 7PM
Thursday: 8AM – 2PM
Friday: Closed
Saturday: Closed
Sunday: Closed

Sitemap | Website Marketing and Design by Now Media Group