Premier Dental Care

New Patient Forms

Call us today to make an appointment for your initial exam!

New Patient Intake Form

Patient Forms

You can either download the form by clicking below, or you can arrive 15 minutes early for your first visit.

This new patient form gives our dentists the information they need to get a good sense of your dental health and your overall health.

New Patient Form – Lehman

General Consent Form

Financial Agreement Consent Form

HIPPA Consent Form

At our dental office, we accept most types of dental insurance, including:

  • Delta Dental PPO / Premier
  • Humana,
  • United Health Care,
  • Cigna,
  • Aetna,
  • Guardian,
  • MetLife
  • We welcome military families, and we also accept Tricare insurance.

If you have any questions about the new patient form, please contact us.

Please note: If you have dental insurance, please bring your dental insurance card and information to your first appointment

Call today to set up your first appointment and discover the Premier Dental Care Difference in the confidence of your smile!