Welcome to our Registration Form page!! To aid you in saving time and verifying insurance benefits, we offer you options for completing your forms prior to your first visit in THREE EASY STEPS!!!
Step 2 Records Release Please print the Form and forward it (by mail, fax or email) to your previous dental provider. They will send any radiographs (X-rays- preferable digital format) and other information required. It is helpful and important to have this information for review by Dr. Amundson prior to your appointment.
Step 3 Personal, Dental Insurance (if Applicable), Dental History
and Medical History
Option 1 (Preferable)Log in to our SECURE Patient Registration area by clicking on the button below. This will be sent directly to us via a Secure Server.
Option 2 Fill out the Welcome to Our Office Dental History Medical History
The following 4 forms should be completed, printed, and brought into the office or emailed to info@thegreatsmile.com3 days prior for your first visit. Forms may be saved to your computer and can be filled out electronically using the interactive fields within the forms. Be sure to save your form after you fill it out to avoid losing your data!!
