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Patient Forms

Prior to your first visit at our office, please print the following forms and fill out with your information.

If you have any questions, please give us a call at 765.453.9389 or email us at [email protected]


Adult New Patient Form

Child New Patient Form

Consent for Care

Dental Insurance Consent

HIPPA Form

Contact Us Today!

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OUR LOCATION

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HOURS OF OPERATION

Find Out When We Are Open

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Monday:

8:00 AM-5:00 PM

Tuesday:

8:00 AM-5:00 PM

Wednesday:

8:00 AM-5:00 PM

Thursday:

8:00 AM-5:00 PM

Friday:

8:00 AM-5:00 PM

Saturday:

Closed

Sunday:

Closed