Patient Registration

We are committed to making your visit as quick and comfortable as possible. 

Existing Patients: We look forward to seeing you again. Kindly fill out the following forms prior to your next visit. Please note any of your contact or medical information that has changed. Forms to be completed:

• Adult Dental and Medical History Form
• Child Dental and Medical History Forms

Kindly return the form prior to your visit via fax or mail them to the address below:  

• E-mail: [email protected]     
• Fax: 973.635.6910
• Address: Chatham Dental Associates Jonathan P. Mundth, DMD Christian P. Mundth, DMD, 140 Main St., Chatham, NJ.07928

New Patients: Welcome to Chatham Dental Associates Jonathan P. Mundth, DMD Christian P. Mundth, DMD. As a new patient, please visit our First Visit Section for more details. We ask that you kindly provide the following information:

Please return the filled out forms, prior to your scheduled visit: 

1. Current X-Rays
2. Forms to be completed:

• Adult Dental and Medical History Form
• Child Dental and Medical History Forms

   3. Notice of Privacy Practices: (HIPPA) Please read this notice as it describes how health information about you may be used and disclosed and how you can get access to this information. Please read it carefully. Notice of Privacy Practices