Patient Forms
Save time by completing your patient forms online or at home, ensuring a relaxed and efficient dental visit. If you have any questions, please call our office at (937) 293-3402.
Submit your patient forms in advance
We understand that your time is valuable. That's why we offer the convenience of completing your patient forms online or at home, allowing you to save time and streamline your visit. Whether you're a busy professional or a family on the go, we're here to make your dental experience as relaxing as possible.
You can access the forms with the buttons below and may complete your forms at your convenience one of two ways: you may fill them out digitally, then save them to your computer and email them to us at [email protected], or you may print them out at home and bring the completed forms to your appointment.
What You’ll Need
Whether filling out forms for the first time or updating your personal information, please have your insurance card and a list of current medications ready. Please inform us immediately if you’ve recently had surgery or a hospital stay.
Fill Out Forms Online
Registration
Prior to your first visit, we will add your personal and insurance information to our records.
Medical & Dental History
We require an accurate medical and dental health history prior to beginning treatment to ensure that we are recommending the best and safest treatment for you and your family.
Private Health Information and Communication
We follow all HIPAA guidelines and will only release medical information to approved individuals.
Notice of Privacy Practices
This notice describes how your health information may be used, disclosed, and how you can get access to this information.
Google Reviews
What a great dental practice! Everyone was so friendly and welcoming! Each room has a view of the beautiful botanical garden, which is stunning and relaxing. My dental hygienist, “Bonnie,” was so friendly and informative about my cleaning procedure. Dr. Platt is a warm and caring dentist who made me feel comfortable and welcome! I highly recommend this dental practice!
Dr. Platt has been helping my husband with TMJ-related discomfort. He and the entire staff were incredibly helpful and friendly! Thanks to all of them for their compassion and eagerness to help!
I came in as a new patient with a broken tooth, and Dr. Platt was ready within minutes to remove it pain-free. This was hands down the best dental experience I’ve had, and it will be my new dental office from here on out.
This place is awesome. The staff is wonderful. They are so kind, polite, and very helpful. You are treated with respect. I would recommend this place 100 percent.
After having cancer in my jaw, I was very scared to see a dentist. Dr. Platt was incredible and made me feel like we were in this together. He heard me (and my fears) and gave me so many options that together, we could find a plan I was comfortable with. He is the first dentist I’ve gone to in 46 years, and it didn’t hurt, and for me, that’s huge! He’s allowed me to not be ashamed of my smile.
Very friendly office staff. Dr. Platt is personable and knowledgeable. My hygienist, Bonnie, was extremely gentle, proficient, and kind. I knew I was getting great care, and Bonnie took the time to hand scale and measure each tooth.
Absolutely fantastic!! I had an emergency, and Dr. Platt was able to see me within 90 minutes. He was able to extract the tooth right there. All the staff were friendly and provided excellent service. He is now my new dentist.
Dr. Ryan Platt was absolutely amazing! My daughter was seen by him instead of her regular dentist because he was on vacation, and he got her in right away and took care of her better than I could have imagined! She is only seven and had to get a tooth pulled right away. The fear in my daughter and myself took over, but Dr. Platt assured us both and cared for her with flying colors.
