Patient Registration

As a new patient, there is information that is essential in order to provide you and your family with optimum dental care. Initially, this data is obtained by asking you to spend a few minutes of your time completing our Registration Forms.

For your convenience, we have provided on-line registration forms that may be filled out and submitted directly to our office. This option will minimize your pre-appointment time. The security and privacy of your personal data is very important to us and we have taken every precaution to protect it.

We ask that you read through each form thoroughly and answer all questions to the best of your ability and knowledge. If we will not be assisting you with your dental insurance, it is not necessary to fill out the corresponding form.

Once you have completed the applicable forms, make sure to click on Submit to automatically transfer your information to us. Subsequently, when you arrive for your first visit, we will have your completed forms ready and available for your signature. Again, we want to stress that this transmission is completely secure and confidential.

We respectfully understand that some patients prefer filling out forms at the office. When you call to schedule your ‘New Patient’ appointment, you will be asked to arrive early in order to allow adequate time for the registration process.

If you have any questions or difficulty filling out our on-line forms, please do not hesitate to call us at 574.264.4161. We will assist you in every way we can.