Online Forms

staff You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Download our Secure Patient Registration Form
Authorization to Release Health Care Information
Consent for IV Sedation
Consent for Oral Surgery

Doctors Carmine A. Colarusso, James F. Connors and Shant J. Baran
2 Jungle Road • Leominster, MA 01453 • Phone 978-534-8300 • Fax 978-840-8508
386 Elm Street • Gardner, MA 01440 • Phone 987-632-7270 • Fax 978-632-7198