Patient Forms and Information
At our office, we strive to make receiving the high-quality care you deserve as convenient and affordable as possible. Read about our insurance and financing policies or fill out our online patient forms below. Then, give us a call when you’re ready to schedule your visit!
Insurance and Financing
To accommodate as many patients as possible, we accept most major dental insurance plans (PPO), and are happy to file your claim on your behalf. We also accept low-interest financing through CareCredit for patients who qualify. If you have questions about your plan, then call our office and speak with one of our experts today.
Online Patient Forms
- Dental History
- Medical History
- Initial Consent For Treatment
- Financial Responsibility
- Notice Of Privacy Practices
- Authorization for Signature on File
Schedule Your Visit by Calling Us Today
If you have any questions or need help filling out your forms, then feel free to call us today! To schedule an appointment, call us at our Gary, IN or Portage, IN locations, at 219-938-2637, or email our office at email@example.com. We proudly serve all of Northwest Indiana and surrounding areas.