- Dental History
- Medical History
- Initial Consent For Treatment
- Financial Responsibility
- Notice Of Privacy Practices
- Authorization for Signature on File
For Your Convenience
We know that your time is valuable, and we respect that. To streamline your first appointment, please print out the following forms and bring them with you to your visit.
We accept most dental insurance policies, and are happy to file PPO insurance claims on your behalf. Feel free to call or email us in advance, and we will let you know if we are in-network with your insurance provider. If you do not have dental insurance, or need additional financing options, we also accept plans from the CareCredit program. If you’d like to learn more about this helpful financing program for medical needs, just ask us.
Link to forms here
If we can assist you in any way prior to your visit, or if you have any questions, please do not hesitate to contact Healthy Smiles in Gary, IN, today by calling 219-938-2637, or by emailing our office at firstname.lastname@example.org. We proudly serve the residents of Gary, Miller, Miller Beach, and all surrounding communities.