New Patient Forms

We have made our new patient forms available to you as Adobe Acrobat files. For your convenience, we recommend printing and completing these forms at home.

Please remember to bring your completed forms with you for your first appointment. If you have any problem getting these files to print properly, please call our dental office and we will gladly send or fax them to you.

• Welcome Form
• Patient Registration
• Medical History
• Dental History
• Privacy Consent Form
• Payment and Appointment Agreement

Download Adobe Acrobat Reader Now

Your Personal Invitation

We invite you to explore our website, browse our Smile Showcase, meet our team, and review our services. Then call the Clinton Township dental office of Dr. Mindy Salzberg-Siegel today to reserve your personal consultation. For more than 25 years, we've delivered the personalized care and excellent service our patients deserve – and they can't stop smiling!

Call us on (586) 416-1444