PATIENT FORMS

We are pleased you have decided to join us!
 
Preventive dentistry will contribute to your overall good health and we are committed to helping you achieve that goal.
 
Help us get you started! Below you will find printable medical history and patient registration forms to register you as a new patient in our office. Save time by getting these forms to us before your appointment. 
 
You can e-mail to schmitzdmd@gmail.com or mail these forms to us ahead of time so that we can have all of your insurance benefit information prepared for you, or you can bring these forms with you on your first visit to our office. We also ask that you bring along all dental insurance cards so we can make a copy for your records.
 
Thank you for your participation and please call 636-464-2002 if you have any questions or concerns.