Patient Forms

Richmond Family Dentist - New Patient Forms - West Main Family Dental

Patients are seen on an appointment basis, and we reserve time specifically with you and the dentist or hygienist. We ask that you complete an online appointment request or call (765) 966-6802 in advance so that we may reserve an appointment time for you.

If you are a new patient to our office, the link below contains our new patient bundle with forms that will need to be filled out when you arrive at our office. Printing forms, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Thank you and please contact our office if you have any questions at all. (CLICK HERE) or on link below to download forms.

New Patient FormsDownload, Print & Complete Prior To 1st Visit

I would like to thank you and welcome you to our office.

I'll start by sharing our guidelines for patients.

Our philosophy is to help each patient achieve the highest level of dental health that is appropriate for them. Recognizing that not all patients have the same dental needs or desires.

With that in mind we would ask you to identify how you would like to be seen in our office by checking which of the three levels seem appropriate for you at this time. Please understand that it is not uncommon for patients to choose a different path after they have experienced our office, but this helps as a starting point.

Level 1:
Reactive care. Patients at this level are generally only interested in solving more urgent problems and not in a comprehensive exam or long- term planning.

In addition, they typically want the treatment performed to be as inexpensive and efficient as possible.

Level 2:
Proactive care. Patients who choose this level of care generally want a thorough examination and want to be Involved In the prevention of present and future dental diseases.
Typically however, they choose repair solutions that are not long term in nature.

Level 3:
Regenerative care. Patients at this level have a high value for their dental health and appearance. They desire a complete dental examination and have a desire to be informed of all findings and the potential consequences of each problem.

Ultimately they want to be involved in creating a long-term master plan for their dental health which includes choosing the longest lasting solutions to their problems.

We hope these different levels make sense to you, and as we stated before, it is not uncommon for patients to change levels after beginning treatment with us. We look forward to seeing you and helping you achieve the level of dental care most appropriate for you.

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