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Printable Patient Forms

If you would prefer to print and fill out the new patient forms instead of submitting them online, please click on each form below and bring them to your appointment:

♦ New Patient Registration Form

♦ HIPAA Consent Form

♦ Financial Policy

♦ Appointment Cancellation Policy

♦ Sleep Apnea Questionnaire

♦ Photo Release Form

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ADDRESS:
15340 23 Mile Road
Macomb, MI · 48044
PHONE:
(586) 580-7517
(586) 247-8730

OFFICE HOURS

Monday: 8:00 am - 6:00 pm
Tuesday: 7:00 am - 7:00 pm
Wednesday: 7:00 am - 5:00 pm
Thursday: 7:00 am - 7:00 pm
Friday: 7:00am - 1:00pm
Saturdays: Closed (*Open select Saturdays 8:00 am - 12:00 pm, call ahead to check)
Sunday: Closed


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  • Home
  • Our Dentists
  • Dental Services
    • Botox for Chronic Pain
    • CEREC Crowns
    • Cosmetic Dentistry
    • Dental Implants
    • Digital Dentures
    • Invisalign
    • Laser Dentistry
    • Pediatric Dentistry
    • Periodontal Treatment
    • Sleep Apnea
    • Tongue Tie Treatment
    • Tooth Extraction
    • Veneers
  • Smile Gallery
  • Testimonials
  • Request Appointment
  • New Patients
  • Financing
  • Blog