your first visit

New Patient Forms

Reduce the amount of time spent in our office by preparing your new patient paperwork at home. You can utilize our online form function by following the link below, or if you’d prefer you can download, fill out and bring with you to your first visit. If you have any questions, please contact us in the office.

A new dental studio

Peace of Mind is a family dental practice located one block West of Downtown Chandler in the East Valley area of Phoenix, Arizona.

welcoming new patients

Dr. Jeremy Silverman  is currently accepting new patients.

new patient

online forms

Complete your new patient forms online.

This link will open your online forms on an external site,  in a new tab.

new patient

printable forms

if you’d prefer to fill out your form by hand, you can download forms to print and fill out. Remember to bring them with you to your visit!

Depending on your browser and computer, forms typically open in a new tab or window within your web browser. From there you may choose to download the pdf, or print directly from the browser window. 

Medical History Form

Dental Concerns Assessment

Patient Comforts

Financial Policy

Privacy Policy

Tips & advice from Dr. Silverman:


Enjoy coffee? Do you often brush after?


Did you know that after drinking coffee it’s important to rinse your mouth with water before brushing? Coffee is acidic and can be hard on teeth. Rinsing will reduce the acidity in the mouth and allow you to brush without worry of damaging the enamel!

For more advice, visit our faq page