Medical and Dental History
You can choose to print and fill out the following forms and bring them to our office the day of your examination appointment OR you can fill out these forms at your examination appointment.
Formulario en Español
We accept the Care Credit financing plan that has been endorsed by the Wisconsin Dental Association. This plan enables patients to borrow money for dental treatment interest-free during the first twelve months of the loan.
We are a Delta Dental Premier Provider
New Patient Registration
Please bring the following information with you to your first appointment:
Insurance cards, both Medical and Dental
Policy holder's Social Security number and date of birth
Physician's name and address
Any prescriptions you're taking
Your family dentist's and your previous dentist's name and address
We will contact your referring dentist for x-rays
Patient portion not covered by your insurance should be paid on day of appointment