Join Our Family

Thank you for your interest in joining our dental family! 

To become a patient at our office please follow the link below. You will need to provide:

  • first name
  • last name
  • today's date for "appointment date"

Please fill out both the new patient form and the medical history form. Upon completion of your paperwork our new patient coordinator will reach out to you!

If you have any questions please call us at 812-423-6113.

New Patient Registration