New Patients

New patients are always welcome here at Springfield Smiles, and we invite you to come join us. We strive to provide the highest quality dentistry for the entire family in a caring environment. We accept most insurance carriers, Visa, Master Card and CareCredit.

If you have any questions, feel free to contact us at 937-390-3077. Click here for directions to our office.

For your convenience, we’ve provided a list of downloadable files below. Please feel free to print them out, review them, and bring them to you’re first appointment.

All new patients should complete the following forms:
  1. Registration
  2. Medical History
  3. Financial Policy
  4. HIPAA acknowledgment
 
Any patients who are interested in TMJ or Sleep Apnea should complete the appropriate additional form.

If you take any medications, please bring a list of them to your first appointment. Doing so will help expedite everything once you arrive at our office. We’ll use the information to complete our computerized records, and then have you sign everything.

We look forward to getting to know you!

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