Patient Forms | Kids & Adult Dental Center Indianapolis, IN & Franklin, IN & Indianapolis, IN

Please print these forms out, fill them out, and bring them to your appointment.

NEW PATIENT INFORMATION
HIPAA FORM
MEDICAL HISTORY
COVID-19 CONSENT FORM

Location

4625 S Emerson Ave, Indianapolis, IN 46203

Phone: (317) 991-4725

Email: [email protected]

MON: 9:00 am - 6:00 pm
TUE: By appointments only.
WED: 9:00 am - 6:00 pm
THU - FRI: 9:00 am - 5:00 pm
SAT: By appointments only.
SUN: Closed

460 N. Morton St. Suite B, Franklin, IN 46131

Phone: (317) 560-5556

Email: [email protected]

MON - TUE: 9:00 am - 6:00 pm
WED: Closed
THU - FRI: 9:00 am - 5:00 pm
SAT - SUN: Closed

7968 Pendleton Pike, Indianapolis, IN 46226

Phone: (317) 552-2101

Email: [email protected]

MON - FRI: 9:00 am - 5:00 pm
SAT - SUN: Closed