The patient history form below is provided for your convenience to print and complete
prior to your scheduled appointment. We will also have copies available at your
appointment if you would prefer to fill it out in the office.
Patient History Form
Cupelli Dentistry is committed to keeping your information secure. This privacy
is available to help patients understand how Cupelli Dentistry remains in compliance
with federal, state and foreign laws.
HIPAA Patient Acknowledgment
Notice of Privacy Practices (Shadyside)
Notice of Privacy Practices (South Hills)