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
This web site uses files in Adobe Acrobat Portable Document Format (pdf) which require Adobe® Acrobat® Reader for viewing and printing. It is available to download free.
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
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
Site Developed by ProSites.com