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Online Patient Forms

 

Thank you for selecting us to provide your child's dental care!

 

To ensure that we can provide you with the best care possible and prepare for your child's dental visit we ask that you complete our online forms. Completing the forms now will save you time at your initial visit.

 

After your initial call to our office, please fill out the New Patient forms. Upon finishing these forms, they will be downloaded to our office and be ready for you when you arrive for your first visit.

 

We have designed our forms so that you will be able to add comments. If you do not feel comfortable answering a question, you may skip it and discuss it with us when you come in.

 

When you have completed a section, click the next button to move forward. Your feedback is always welcome when you visit our office.

 

Thank you for your time.

Make an Appointment

Smiles In Motion

583 Lakeland Drive

Chippewa Falls, WI 54729

info@sim4kids.com

Tel: 715-723-2000

Fax: 715-723-3712

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Smiles In Motion

1701 W Knapp St

Rice Lake, WI 54868

info@sim4kids.com

Tel: 715-723-2000

Fax: 715-723-3712

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© 2015 by Smiles in Motion, S.C.

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