New Patients
New patient information and forms
Your First Visit
How to Prepare
• Fill out new patient forms located on this page prior to your first visit
• Come with any questions for us regarding your treatment and financial needs
What to Expect
• Approximately 60 minute appointment
• Comprehensive examination including necessary x-rays
• Thorough description of findings and opportunity to discuss treatment and financial considerations
New Patient Forms
Please fill out each page of our new patient forms prior to your first visit.
Having these forms complete ahead of time can help ensure a quicker and more seamless transition to the care of our office.
You may fill out the forms directly below. As you complete each of the 5 pages,
please ensure that you hit the “submit” button on the left of each page to submit your responses. Thank you!
If you are a new patient filling out the forms below, please note that it is easiest to fill them out using a laptop/desktop computer when one is available.
Schedule an appointment today!
Please give us a call if you have Aetna, Delta Dental Premier, or Paramount benefit plans. We are in-network providers for these plans.
Our Northside Office
625 West Mill Rd. Evansville, IN
(812) 464-9061
Available Appointment Times
Monday: 12PM - 7PM
Tuesday: 8 AM - 7PM
Wednesday: 8 AM - 5 PM
Thursday: 8 AM - 5 PM
Friday: Closed
Saturday: Closed
Sunday: Closed