New Patient Registration Align Senior Care

New Patient Registration Align Senior Care

Please fill out this form if you are an Align Senior Care Member (also known as AllyAlign) and would like to sign up for dental services with Enable Dental.

Printable/Downloadable New Patient Consent Form (must email or fax to us)

Imprimible/Descargable Nuevo Formato de Consentimiento de Paciente (debe enviarnos un correo electrónico o un fax)

Register Online - Align Senior Care
REGISTRO EN LÍNEA - ALIGN SENIOR CARE

Questions Or Need Help Filling Out The Form? Contact Us Below.

Fax: (866) 815-3719