Click the links below to download print-friendly copies of these important forms. Please fill out and sign them. Then bring them with you to the office for your appointment. Thanks!
- New Patient Information (Page 1)
- Dental History (Page 2)
- Fee Quote and Consent
- Financial Guidelines
- Grounds for Dismissal
- Informed Consent
- Patient Consent to Share Protected Health Information
- Your Rights with Respect to This Consent
Have a question about one of these forms? Need help? Call 317-731-5203 or visit our contact page to get in touch.