New Patient Forms

 

We are delighted to Welcome you to our practice and pleased that you have chosen us to serve your dental needs. To facilitate your upcoming appointment, please print and complete the new patient registration packet and bring the completed forms with you to your initial appointment. If you do not have time to complete the forms please arrive 20 minutes prior to your appointment time. Bring any dental insurance cards and benefit information with you. If you are unable to print our forms please call and we will gladly fax or mail them to you.

 

We respectfully ask our patients to be prompt and keep their scheduled appointments. We understand our patients have busy schedules and we are committed to staying on time. We do not double book appointments. Your appointment time is scheduled specifically for you. If you are unable to keep your scheduled appointment, we ask that you notify us at least 48 hours in advance.

 

Again we thank you for choosing our Dental Practice, and we look forward to meeting you.

 

 

 

Please download Adobe Acrobat below to view/print forms:

 

 

 

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Dr. Ron Burgmeier - Olathe Dentist - 913-764-1169
13025 S. Mur Len Rd., Ste. 250 - Olathe, Kansas 66062