We have provided our new patient packet for you to review, download, and complete before your visit. This saves you the effort of filling out the form when you get to our office.
Also, for our existing patients, we request you update your health history, if necessary, and return it to our office at your next visit.
New Patient Packet
Existing Patient Medical Update Form

Medical History Form

Financial Policy
Appointment request
Need an appointment with a dentist in Fort Wayne ? Requesting an appointment at our Fort Wayne, IN family and cosmetic dental office is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule. Start your journey towards a beautiful smile with us today!
Patient Name*
Phone Number*
Email Address
Are you a current patient?
Best time(s) to call?
Preferred Appt Date
Preferred Appt Time
Describe the nature of your appointment or any other comments