New Patient Forms - Michigan & Kentucky

Depending on what is scheduled, your initial appointment will either consist of an exam, dental x-rays and a gentle cleaning (if applicable) or a limited exam and dental xray of the area of concern if you are coming in for pain or a consultation. Sometimes we are able to start treatment the same day.

Please assist us by providing the following information at the time of your consultation:

• Any x-rays taken by a previous dentist, if applicable.
• A list of medications you are presently taking.
• If you have dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: All patients under the age of 18 must be accompanied by a parent or guardian.

Please alert the office if you have a medical condition that may be of concern prior to treatment (i.e., diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e., heart medications, aspirin, anticoagulant therapy, etc.).