Patrick Liu, DDS

3301 N Miller Rd. Suite 151
Scottsdale, AZ 85251
480.949.5579

• First-time patients can print and pre-complete these documents and bring them to their appointment.
• They can be downloaded and printed individually or as a group.

1. Patient Information, Insurance, and Dental/Medical Questionaire (2 pg pdf)
2. Financial Policy and Statement of Financial Responsibility
3. Acknowledgement of Receipt of Privacy Notice
4. Document Bundle (all of the above in a 4 page pdf)