New Patient Information

Thank you for choosing Midwest Dental. We can't wait to meet you in person.

For your convenience, we recommended you complete the forms below and bring them to your first visit. In addition, if you take a pre-med before dental appointments, please do so prior to your arrival and bring a list of all current medications. If you are transferring from another dentist, please ask your previous dental office to forward any current x-rays to our practice.

Adult Patient
Health History Form

Download Form

Child Patient
Health History Form

Download Form

HIPAA Acknowledgement
and Authorization

Download Form

Midwest Dental's Financial Policy

Please read, agree to, and sign our financial policy prior to any treatment.

Download Form

Pre-Medication
Requirements

Patients with certain medical conditions may need to take medication before seeing the dentist.

Read Form

About our
Privacy Practices

We are required to provide you with information about our procedures to safeguard your personal information.

Read Form

Day of Your Appointment

Please arrive 15 minutes before your scheduled appointment. This will allow us to finish any paperwork and stay on schedule with your appointment. Please bring the following items with you to your first appointment:

If you have any questions about your upcoming visit, please always feel free to give us a call. We're here to help.

See you soon!