New Patient Forms

Child Dental and Health History
(Click above to download the file.)

Dental Health History
(Click above to download the file.)

Patient Registration
(Click above to download the file.)

X-RAY Release Form
(Click above to download the file.)

HIPAA Consent Form
(Click above to download the file.)

Privacy Practices HIPAA
(Click above to download the file.)

Financial Policy
(Click above to download the file.)

Supplemental Informed Consent Form
(Click above to download the file.)

COVID Patient Screening Form
(Click above to download the file.)

Banner
No form settings found. Please configure it.
Location & Hours

Our Location

49 E Main Street | Milan, MI 48160

Office Hours

Our General Schedule

Monday:

9:00 am-4:00 pm

Tuesday:

9:00 am-4:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-4:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed