Quick Patient Registration

Want to see Dr. Scott faster and spend less time in the waiting room?  Save time for your endodontic appointment by pre-registering online.  Just click the Online Registration Form below and be sure to click the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Associated Endodontists of Melbourne-Online Patient Registration Form-Brevard Endodontist

Online Registration Form button

But, if you prefer to print out and complete the new patient paperwork as a hard copy, please click the New Patient Packet link below. Please print and complete the forms prior to your arrival.  This will help to speed up the new patient registration process and get you in to see the doctor faster!