Cornerstone Dental Arts
Cornerstone Dental Arts

Patient Forms

On your first visit, in order to know  you better, we’ll ask you to complete the registration forms. To allow  sufficient time for this, please arrive a few minutes early.  (If you like, please download and complete  the forms prior to your first visit using the links below.)

Patient Release Form
Financial agreement.pdf
Adobe Acrobat document [6.6 KB]
Contact Information for Protected Health Information
Protected Health Information.pdf
Adobe Acrobat document [72.1 KB]
Patient Medical History
NeebMedHist.pdf
Adobe Acrobat document [625.4 KB]
First Time Patient Registration
PatReg.pdf
Adobe Acrobat document [295.8 KB]

Call us at: 317 462-7696

 

Cornerstone Dental Arts

920 N State Street

Greenfield, IN 46140

Email: cornerstonedds@gmail.com

 

Office Hours

  • Mon.    7:30 a.m-4 p.m.
  • Tues.    7:30 a.m.-4 p.m.
  • Wed.    7:30 a.m.-5 p.m.
  • Thurs.  7:30 a.m-4 p.m.
  • Closed  Friday 


Outside our regular business hours, please note our emergency care information.

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