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FORMS

Save time during your next visit by completing patient forms before your appointment.


Forms

FOR NEW & CURRENT PATIENTS

Paperwork can be exhausting. We have posted our New Patient Information Packet and additional (optional) forms for you to fill out prior to your visit. No time to complete the forms before your visit? No problem, we just ask you to arrive 15-20 minutes early to allow time to complete these prior to your scheduled appointment time.

NEW PATIENT INFORMATION PACKET

Please fill out forms regarding your patient information and medical history, and review our privacy policy.


RELEASE OF PROTECTED HEALTH INFORMATION TO A DESIGNATED ADULT

This form allows your dental providers and the staff at Waukee Dental to discuss your dental treatment and health information. Common individuals on the form are parent/guardian, spouse and children.


EMAIL USE AUTHORIZATION

Not a required form; however, it is necessary if you would like to discuss treatment or schedule appointments via email in the future.


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