Patient Forms

We utilize a 'touch-free' check-in and billing process. We will need your email address, date of birth and address in order for us to provide you access to the Patient Portal System (complete forms online, obtain yearly tax receipts, pay a balance, watch various treatment videos that the doctor or hygienist recommended, receive appointment reminders, etc.).

New patients, please call our office (727) 321-1427, or email us domainadmin@spilmandentistry.com and we can send you an invitation email to the Patient Portal (check spam/junk as well). Click on 'Log me In' which will open a screen to verify your identity. The email address is locked down at this point and you will be required to enter your unique identifiers which need to be different for every patient. You will then need to enter a password that must be atleast 8 characters long, contain 1 capital letter, a number and a special character (!@#$%^&*+=). Retype the password and click 'submit'.

Once you have logged in, click on ‘Go to my forms’ then, read, complete and sign any required forms before you arrive. If this is not possible, you will need to arrive 15 minutes early to fill out the forms through our Kiosk.  Email or call us if you have any questions.

We look forward to meeting you!!!

Email: domainadmin@spilmandentistry.com

Office Number: (727) 321-1427

Current patients, please click on the link below to access your previously created Patient Portal.

Patient Portal

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Jeffery Spilman, DDS
4899 5th Ave N
St. Petersburg, FL 33713
(727) 321-1427
Saturday hours and Emergency
Same-Day Appointments Available