New Patient Forms
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Are You A First Time Patient?

Because Everyone deserves to Smile

Please fill out all three forms to help your appointment move quicker and smoother.

1. New Patient Health History Form

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2. HIPAA Patient Consent Form

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3. Financial Agreement Form

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Don’t hesitate to call!

Feel free to call us with any questions

(719) 488-3014

Related Services

insurance form

No Insurance? No Worry!

Are you a patient of our practice without dental insurance? Then join our Smile Club, taking care of your preventive care with a monthly subscription, and save money today!

Sign Up Now!

office

Be Our Guest

Everyone Is Welcomed to Our Office!

We are located at the East corner of 1-25 and Hwy 105. Just behind Woodmoor Lake and at the base of Monument Hill.

location

1777 Lake Woodmoor Drive, Monument, CO 80132

Our Office Hours

  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • Sunday
  • 8:00 AM - 5:00 PM
  • 8:00 AM - 5:00 PM
  • 8:00 AM - 5:00 PM
  • 8:00 AM - 5:00 PM
  • 8:00 AM - 5:00 PM
  • Closed
  • Closed
Appointment Request

Compassionate & Family Friendly Care

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