New Patient Forms

Download a PDF copy of our New Patient Registration and Medical History here

Download a PDF copy of our Office HIPAA Policy here

Download a PDF copy of our Office Financial Policy here

Once you make an appointment, our office will ask you to provide patient registration details such as name, address, phone number, responsible party, etc. You can save time by printing and filling in these forms yourself. Make your first dentist office appointment even faster by using these printable new patient forms. For more information on how to make best use of these forms, please call our office at: (937) 836-7911.

After you've completed the medical history and new patient forms, simply bring them with you on the day of your visit. Although it's not required, bringing completed forms with you will save time spent at our office and help make your first appointment less troublesome. If you have any problems downloading the forms, be sure to call our office and we will gladly send them by mail, e-mail, or fax them to you.