Rounded Rectangle:

PATIENT FORMS

New Patients:

  We request that new patients arrive for their first appointment 10 minutes early to complete your health history form and HIPPA Acknowledgement form. You may print them from this website and bring them in already completed. 

 

Antibiotics may be required before any procedures (including cleanings) for the following conditions:  joint replacements, Prosthetic cardiac valve, previous endocarditits, Cardiac transplantation recipients with cardiac valvular disease and some instances of Congenital heart disease.  Please check with your cardiologist, orthopedic surgeon or family doctor if you are unsure if you are required to do so.

 

 If you have had recent x-rays (obtained in the last 12 months) from another dentist, please contact them and bring them to your first appointment or have them sent to us at:

 

         Village Dental Center

         PO BOX 327

         Goodrich, MI  48438

        (810) 636-2808 phone

        (810) 636-4010  fax

Adult New Patient Form
Child New Patient Form