121 Prosperous Place Suite 12B
Lexington, Kentucky 40509

(859) 263-1888

Monday thru Thursday, 8am-4pm

New Patient Forms

Expedite your first visit and the check-in process by completing our patient forms.

For our New and Revisiting Patients

We want your experience to be timely and stressfree, without the surprise and hassle of required forms.

During your first visit to our office, we will establish the foundation for treating you as a patient for years to come. We make sure to obtain significant background information pertaining to your dental history and ask several questions to help us build a trusting relationship where you no longer fear, but enjoy visiting the dentist.

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Our Patient Forms

For your convenience, please print and fill out these forms so we can expedite your first visit:

Full Registration
New Registration Packet*

*Contains all required forms for first time visit, except Child History Form
**Only required if minor is receiving dental care

When you check in, we will ask you for these forms as well as your insurance card and a photo ID.
Please have ALL items ready at check-in to prevent wait time.

Accepting All Major Forms of Payment

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