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Patient Forms

New Patient >> Patient Forms

All the Patient Forms

You Need for Your Visit to Dr. Jerry Maymi

For a more convenient visit to our South Jordan, Utah dental practice, we invite you to print out the following patient forms. Please bring the completed forms to your first appointment with Dr. Maymi.

Patient Information Sheet

patient_info_sheet

Medical and Dental History

Medical History

General Dental Treatment Consent Form

COVID-19 Pandemic

covid-19_

Consent To Proceed

Consent to Proceed

Office Financial Policies And Federal

Truth-In-Lending Statement

Fed. Truth in Lending-Eng

Financial Policy

financial policy

Completing these forms before your appointment ensures that you spend more time focusing on your oral health and less time with paperwork. Please contact our office if you have any questions about these patient forms.

Make an Appointment

If you need high quality dental services, contact us!
Сall at (801) 253-7553 to schedule an appointment.

You can also use our online contact form to request an appointment.

Our Advantages

Complete Care on Your Schedule

Bringing Life to Your Smile

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Experienced Dentist​

With over 25 years of experience, You can rest assure you will receive the most professional treatment at Dr. Jerry F. Maymi and Associates.

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Advance Treatment​

From fillings to implants to teeth whitening and more, at Dr. Jerry F. Maymi and Associates we have the experience and equipment to provide you with the best treatment.

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Guaranteed Results​

No matter what type of dental service you need, you can trust Dr. Maymi will give the results you are looking for.

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Modern Equipment

Using the most advanced equipment and techniques, Our dental team is always committed in giving you the perfect smile.

New Patient

We are committed to your satisfaction and invite you to call our South Jordan, Utah dental practice today to learn more about the restorative, cosmetic, and preventive treatments we provide to improve your oral health and restore your smile.

Need Assistance?

(801) 253-7553

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