Patient Registration

Bergen Oral & Maxillofacial Surgery in Hackensack, Westwood, Ridgewood NJ

If you would like to save time on the day of your initial visit, please feel free to fill out our convenient pre-registration form (click below for form) and click on “submit” or print and mail it to the office in which you will be seen.

Online Patient Registration

You may preregister with our office by filling out our secure online Patient Registration form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Secure Patient Registration Form

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Hackensack Office Phone Number 201-343-8297
Westwood Office Phone Number 201-664-5656
Ridgewood Office Phone Number 201-444-4137
      Franklin Lakes
Franklin Lakes Office Phone Number 201-808-8700

Personalized, gentle, comprehensive patient care is our number one priority.