Peter King, DDS
Peter King, DDS
Glen Rock Cosmetic Dentist Dr. Peter King
201-857-2661
849 Lincoln Avenue
Glen Rock, NJ 07452

patient information

Patient Forms

To continue making your dental experience pleasant, we have conveniently provided our digital dental forms below, so that you can fill them out in the comfort of your home using your home computer or any mobile devices and submit them to us online.


form iconPatient Information


form iconDental Insurance


form iconDental History


form iconHealth History


form iconCOVID-19 screening (for patient: Pre-treatment screening)


form iconCOVID-19 screening (for patient: Day of Appointment screening)


form iconAcknowledgement of Notice of Privacy Practices


form iconHIPAA Notice of Privacy Practices

patient information

Glen Rock Cosmetic Dentist

Office Hours

  • Monday: 8:00am - 5:00pm

  • Tuesday: 8:00am - 5:00pm

  • Wednesday: Closed
  • Thursday: 8:00am - 5:00pm

  • Friday: 8:00am - 2:00pm
    (Every Other Fri.)
  • Saturday: 8:00am - 1:00pm
    (Every Other Sat.)

Contact Info
Phone | 201-857-2661
Fax | 201-857-2599
E-mail |

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