Patient Forms

Please print and complete these forms at home before your first appointment. If you need assistance with downloading or printing these forms, please contact our office:

Assignment of Benefits
Dental History
Financial Policy
HIPAA Privacy Practices
Medical-History
Patient Registration

For your convenience, our Patient Forms are available for download here in Adobe Acrobat PDF format. The Adobe Acrobat Reader is FREE and can be downloaded by clicking on the icon below.

Our Office
Advanced Care Dental
600 Pleasant Oak Dr.
Oregon WI 53575
Phone: (608) 835-3388
Fax: (608) 835-3386