Your first visit to our office will involve some paperwork so we can get health and dental information from you.  We have provided some of those forms here if you would like to fill them out ahead of time. You may enter the information directly on the form and then print it to bring to the office or you may print the blank form and fill it out by hand.  Please do not e-mail personal medical information. You can also come 15 minutes early for your first appointment and receive copies from us to complete.

 

Patient Health Record

Health History

Financial Policy

Patient Acknowledgement

HIPAA Compliance

Privacy Policy

Appointment request
Need an appointment with a dentist in Minden ? Requesting an appointment at our Minden, NE family and cosmetic dental office is now easier than ever. Fill out the form below and we'll contact you to find a time that fits your schedule. Start your journey towards a beautiful smile with us today!
Patient Name*
Phone Number*
Email Address
Are you a current patient?
Best time(s) to call?
Choose Location:
Preferred Appt Date
Preferred Appt Time
Message
Describe the nature of your appointment or any other comments