Patient Forms

Click on the link below to complete the patient forms on your computer. When finished entering information, please click "Submit" at the bottom of the last page. Each form has multiple pages. We will then have you sign the completed forms when you arrive at your scheduled appointment. If you have any questions, please call our dental office in Council Bluffs for assistance. 712.323.3615 Thank you.

At your first visit please let us know if you would like to be signed up to get your future appointments confirmed by text or email for your convenience.