Patient Forms

We love to make you smile and can’t wait to care for you! Call 734-426-8360 to get started today. Below are links to our digital patient forms.  Once you’ve downloaded and completed your forms, you can email them to us at dexterdentalstudio@gmail.com.  Filling out your forms online saves time and paper.

Adult New Patient Forms

Patient Registration Form

New Patient Health/Medication List

Dental History

HIPAA Release Form

Child New Patient Forms

Patient Registration Form

Patient Health/Medication List, 13 & Older

Growth & Development Form, 12 & Under

HIPAA Release Form

Consent to Treat Minor Without Parent/Legal Guardian

Authorization of Minor Accompany Form

Annual Medical Health Update

Patient Health/Medication List

Dental Health Plan Subscription

Whole Dental Health Subscription Contract

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We provide a variety of individualized health packages to meet your budget and needs.

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We follow precautions for COVID-19 to keep everyone safe.

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