Patient Forms

Patient Forms

If you are a new patient to our office, the attached files contain our new patient forms that will need to be filled out when you arrive at our Hebron dental office. Printing them, filling them out and bringing them with you will allow us to attend to you more quickly than completing them on your arrival. Thank you and please call our office at (219) 996-3311 should you have any questions at all.

HIPAA Omnibus Rule

New Patient Forms 

COVID-19 Screening 

Health History 2020

 

This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.

 

 

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56 Nichols StHebron, IN 46341Get Directions(219) 996-3311

Testimonials

Hebron IN Dentist, Dr. Carla Brink is dedicated to Family & Cosmetic Dentistry with services including Dental Exams, Dental Makeovers, Teeth Whitening, Veneers, Crowns, X-rays, Fluoride, Cleanings, & more.

2024 Carla Brink, D.D.S.
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