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Online Patient Registration

READ AND FOLLOW THESE IMPORTANT DIRECTIONS BEFORE PROCEEDING

1. CLICKCOMPLETE, and SIGN these forms before your appointment.

2. Be sure to press the SUBMIT button before closing the browser.

3. Please make sure to WAIT for the form to process submission before closing out. If you exit before the form is fully sent, we may not receive it.

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HIPAA Notice

The NJ Center for Oral Surgery maintains strict patient confidentiality and they are fully HIPPA compliant. All electronic medical records, personal and financial information is stored securely with multiple layers of protection. Your information is safely stored with redundant data backup systems and recovery software including secured off-site backup. All team members are trained on privacy rules and regulations.

NJ Center for Oral Surgery

Please complete the form below and our scheduling coordinator will get back to you to confirm an appointment.

Privacy Policy

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