All Smiles Dental

Patient Forms

Patient forms are available in our office, or you can download them below

Optional: print at home

  1. Download a blank copy below.
  2. Print it and complete it by hand, if you choose.
  3. Bring the completed form to your appointment.

Optional: send by email

  1. Download and complete the form.
  2. Save the completed copy to your device.
  3. Attach it to an email and send it to allsmilesdentaloffice@gmail.com.

Need help accessing a patient form or need another way to complete it? Please call us at 765-362-9245.

Insurance Authorization Release Form

Download

HIPAA & Authorization to Share Information

Download

Visit us

Location and hours

All Smiles Dental
1316 Mill Street
Crawfordsville, IN 47933
Monday
8:00 am - 5:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday-Sunday
Closed
Get directions (opens in a new tab)