First Visit Forms | Smiles on Niles

Before Your Visit

Complete Your Forms

Prior to your first visit, please complete the following forms and submit them to our office as soon as possible:

Patient Registration, Health History and Medication List
Patient Records Release Request Form
HIPAA Authorization Form
Electronic Communications Form

Download All Forms Records Release Form

Policies

Office Policies

Getting Started

Being well-prepared for your appointment will ensure that our team has all of the needed information to provide the best possible dental care for you. It also will help relieve any unnecessary anxiety you may be feeling prior to your visit.

Take some time to familiarize yourself with Smiles on Niles and explore who we are and the services we offer.

We look forward to your first visit.

Cancellation Policy

We here at Smiles on Niles feel everyone's time is valuable. We request all cancellations or schedule changes are given with at least 24 hours notice. Last minute cancellations or failures to show may result in a cancellation fee. Multiple offenses may result in dismissal from the practice.

Insurance Information →