Complete Your Patient Forms Online
Save time before your appointment by completing your patient paperwork online. Choose the option that best describes you to get started.
New Patients
Visiting Lowell Dental Care for the first time? Complete your New Patient Packet online before your upcoming appointment.
Established Patients
If you've visited our office within the past two years, complete this packet to update your medical history, HIPAA privacy acknowledgement, and communication preferences.
Not sure which forms to complete? If it's been more than two years since your last visit, please call our office at (616) 897-8491 for assistance.
Please download the necessary forms, fill in your information, and save them as either a PDF or a .docx file. Once completed, you can securely upload your forms at the bottom of this page.
Dental & Medical History Form
Dental Information Form
Office Policy & Financial Agreement
Upload Your Forms Here!
Have Questions?
(616) 897-8491
Hours:
Monday: 7:30am – 4:30pm
Tuesday: 7:30am – 4:30pm
Wednesday: 7:30am – 4:30pm
Thursday: 7:30am – 3:30pm
Friday: CLOSED
Saturday: CLOSED
Sunday: CLOSED
HIPAA & Privacy Disclaimer:
Please do not submit sensitive personal or health information through this form. This form is for general inquiries only. If you need to discuss private health information, please call our office directly. By submitting this form, you acknowledge that electronic communication is not always secure, and you agree to be contacted by Lowell Dental Care regarding your inquiry via phone, email, or text regarding your inquiry.