We are glad you have chosen us to protect those pearly whites! We look forward to meeting you. You can make your first visit as efficient as possible by completing the forms below in the comfort of your own home. Just open the links below, fill out each form, print them, sign them, and bring them to your appointment. You may also print the forms blank, fill them out in pen, sign them and bring them with you. Or you may also fill out these forms when you get to the office, but please arrive early for your appointment if you need extra time to complete these forms.
Fill out, print and sign each of these forms if you are a new patient. The Notice of Privacy Practice form is optional and provided for informational purposes only. You may read it here, print it or request a printed copy at the office. This is a Notice of Privacy Practices statement that you will acknowledge receiving on the second page of the account registration form.
Call (937) 294-6476 to Schedule an Appointment
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