Patient forms - WESTERN PENNSYLVANIA ORAL & MAXILLOFACIAL SURGERY

Online Patient Forms

Please fill out before your visit

Before coming in for your scheduled appointment with Dr. Krakora, save yourself some time by filling out these online forms:

Post Op Instructions

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 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.

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Request your consultation

I understand the information disclosed in this form may be subject to re-disclosure and may no longer be protected by HIPAA privacy regulations and the HITECH Act.

Update

We have always exceeded the strict OSHA-mandated protocols to maintain a highly sterile environment within our offices. These guidelines were created to safeguard against the spread of severely contagious diseases such as tuberculosis and measles, and they are equally effective in managing the spread of influenza and coronavirus.

In addition we have added more rigorous disinfecting techniques and sterilize common areas more often. Our office has added a sanitizing system directly to our HVAC which “cleans” the air continuously for an added safety measure. We have minimized contact with staff as much as possible by utilizing the internet and phone contact when possible, and have added the option for some to do a virtual visit.

We are working hard to keep you safe!