Download and Fill Out Our New Patient Forms

To help make your life easier, we’ve provided our new patient forms online so you can fill them out before your visit! Please arrive at least 15 minutes before your scheduled appointment to ensure that all of your paperwork is in order, and so we can address all of your questions and concerns before your consultation.
- Complete New Patient Form Package
- Medical History Form
- Notice of Privacy Form
- Patient Information Form
- Authorization For Release of Protected Health Information Form
- Authorization For Signature on File Form
Schedule your visit by calling our office
Save time during your first visit by filling out our new patient forms ahead of time! Once you’ve completed them, schedule a consultation with us by calling Dimples Family Dentistry in Norwalk, IA, today at (515) 256-1176.