Are you ready to get the dental care you need? Here are our new patient forms to save you some time when you visit our Bloomington office. Please follow the links below and fill out, sign and submit these forms before your first visit.
New Patient Form
Form A Smile Assessment Questionnaire
Form B Consent for Use Disclosure of Health Info Verbal Release
Form C Dental Treatment Consent
Form D Finance Policy
We are happy to announce we offer CareCredit health credit card with 0% interest for dental procedure financing. Learn more by visiting www.carecredit.com or contacting our office. Ready to apply? Apply online for your CareCredit healthcare credit card today.
You’ll be smiling brighter in no time!