Forms: Initial Visit Forms


Medical History Form

Complete form, sign and bring to first visit

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Dental History Form

Complete form, sign and bring to first visitView Form

Notice of Privacy Practices

For patient reference, does not need to be brought inView Form

Acknowledgement of Receipt of HIPAA Privacy Policies and Procedures

Complete form, sign and bring to first visitView Form


Financial Guidelines

Complete form, sign and bring to first visitView Form

Forms: Other Forms and Information


Consent to Discuss Treatment With Another Party

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Permission Slip to Treat Minor Patient

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Drug Take Back Program - Chisago County

Learn how you can properly dispose of unused medications.Learn More

Invisalign & CEREC

Available here!
Our other services include:
Comprehensive Preventative & Restorative Dentistry
Dental Implants
Invisalign
CEREC
Digital Imaging
Custom Whitening Trays
Veneers
Custom Mouth Guards & More!

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Finance

We have financial options available to our patients! Call us with any questions!

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