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New Patient Forms

Our patient forms are available for download below:

New Patient Forms – Age 17 and Under (7 Pages)

Information Form – 17 and Under
Acquaintance Form – 17 and Under
Health History
HIPAA Notice of Privacy Practices (2 pages)
HIPAA Acknowledgement Form
Signature Sheet

New Patient Forms – Age 18+ (7 Pages)

Information Form – 18+
Acquaintance Form – 18+
Health History
HIPAA Notice of Privacy Practices (2 pages)
HIPAA Acknowledgement Form
Signature Sheet

What You Should Know About Dental Insurance


Records Transfer Request Form


Contact Us

We will respond by our next business day. You may prefer to call us at (573) 446-2687. Please leave a message if we are busy or closed. Thank you!

Office Hours

Monday:

8:00 AM-1:00 PM

2:00 PM-5:00 PM

Tuesday:

8:00 am-11:00 am

12:00 pm-5:00 pm

Wednesday:

8:00 AM-1:00 pm

2:00 PM-5:00 PM

Thursday:

8:00 AM-1:00 PM

2:00 PM-5:00 PM

Friday:

Closed

Saturday:

Closed

Sunday:

Closed