Smiles Plus Dental Care
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  • Our Team
  • Services
    • Prevention & Dental Hygiene
    • Oral Cancer Screening
    • Periodontal Health
    • Fillings / Restorations
    • Dental Crowns
    • Dental Bridges
    • Root Canal (Endodontics)
    • Extractions
    • Dental Implants
    • Whitening
    • Orthodontics
  • Payment Options
  • Reviews
  • Forms
  • Contact Us
  • Home
  • Our Team
  • Services
    • Prevention & Dental Hygiene
    • Oral Cancer Screening
    • Periodontal Health
    • Fillings / Restorations
    • Dental Crowns
    • Dental Bridges
    • Root Canal (Endodontics)
    • Extractions
    • Dental Implants
    • Whitening
    • Orthodontics
  • Payment Options
  • Reviews
  • Forms
  • Contact Us

Patient Forms

You can save time by printing these forms and completing them before your first visit. After printing and completing these forms, please email them to our email address at: smilesplus@frontiernet.net. We look forward to meeting you!  
1. New Patient Health Questionnaire
File Size: 584 kb
File Type: pdf
Download File

2. Patient Consents and Policies
File Size: 817 kb
File Type: pdf
Download File

3. Notice of Privacy Policy
File Size: 171 kb
File Type: pdf
Download File

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Smiles Plus Dental Care of Gillespie  |  (217) 839-2135                Smiles Plus Dental Care of Pittsfield | (217) 285-4084
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