Patient Forms
Please print and fill-out the forms below and bring them in, along with your insurance card to your scheduled appointment.
Patient Information
Medical History
Financial Policy
HIPAA Release Form
HIPAA
Consent Form
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Our Office
Edmond
Dr. Brock gave a very thorough exam and showed genuine care for not only my teeth but also my health. My hygienist, Eryn, was very sweet and gentle during the cleaning. She is very friendly and makes sure I felt comfortable! Little things like providing protective sunglasses during the cleaning are a plus! The office is very clean and professional.
Hannah M
I have had the best experience at this office! From the moment you walk in, you are treated with warmth and kindness. The staff is always so friendly and prompt. Dr. Brock is so thorough and always goes above and beyond to answer my questions. Eryn is a wonderful hygienist and is so fun to talk to. I love that she always explains exactly what she's doing and why while she's cleaning my teeth. I can't recommend this dentist enough!
Brooke G
Dr. Brock and my hygienist, Eryn, were very thorough throughout the exam. They were careful, detailed, and professional. From the greetings by the entire staff and to all the little things that make visiting the dentist a great experience . . . This place has it all
Kevin M
Best experience I have had at the dentist! The entire staff was kind and considerate. Dr. Brock was very skilled and personable. Eryn did a superb job cleaning my teeth. The entire experience was easy and painless. Excellent facility and very clean. I will definitely be going back and have already made an appointment for my 3 year old.
Christine S
I have experienced the care of both Dr. Jones and now Dr. Brock, and I have been just amazed at how much the individuals in this office care for their patients. Whether you need a little extra special care or just a regular cleaning, the experience will be top-notch. I have to say this is the first office I've been to where I don't mind going to the dentist. I even sometimes look forward to it. Love this place!
Catherine D
Very contentious about your oral health. Staff and Dr. Brock very friendly, discuss any questions you have. Use modern, up to date equipment for cleaning, provide nitrous upon request to help you have a great comfortable dental experience.
Tom R
Very good experience. Kind and gentle.
Ellen P
Great experience, very thorough in explanation and developing a treatment plan for me.
Mike Y
Dr. Brock and his staff were wonderful and professional
Kyle D
Dr. Brock has always been so well put-together and professional. He is an amazing dentist would recommend to anyone!
Cameron C
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