Patient Forms
Click to download and bring Patient Form(s) on the day of your appointment. Each patient will need to fill out a Health History Form and HIPPA Privacy Consent Form. Each family will need to fill out a Payment Information Form.
Dr. H. Nicholas Bretl, DDS
Dr. Ben Wasleske, DDS
A Different Kind of Dentistry.
Click to download and bring Patient Form(s) on the day of your appointment. Each patient will need to fill out a Health History Form and HIPPA Privacy Consent Form. Each family will need to fill out a Payment Information Form.