Online Forms

At Main Street Smiles we value your time. In an effort to save you time in our office, you can download and complete our patient form(s) prior to your appointment.

  • You will need AdobeReader® to download and complete the forms. Click here to download.
  • Download the required form(s). Print out the form(s) and complete the required information.
  • Fax your printed and completed form(s) to our office or bring them with you to your appointment.

New Patient Health History Form – Required

Please complete this form as it lets us know the history and current state of your health: Download & Print Form

Patient Registration: Download & Print Form

Financial Policy: Download & Print Form

Notice of Privacy Practices: Download & Print Form

Authorization for Release of Information and Notice of Privacy Practices: Download & Print Form


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Our Location

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Hours of Operation

Our Regular Schedule

Primary Location

Monday:

8:15 am-4:30 pm

Tuesday:

8:15 am-4:30 pm

Wednesday:

8:15 am-4:30 pm

Thursday:

8:15 am-4:30 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed