Visiting Brownsburg Dental Professionals, PC for the first time is an exciting time. You get to visit one of the best dentists in the Brownsburg area, Dr. John Loeffler, while also building relationships with the kind staff. Beyond, who doesn’t love making sure they’re teeth are nice and healthy?! We want to make sure that your first visit is as seamless as possible, which is why we ask you to complete the following before coming into the office.
First Dental Appointment
If this is your first time visit with our office, we will ask for you to fill out our Patient Registration and Medical History forms which are available on our website Click here to print them and fill them out prior to your appointment. If you have a list of medications that you are on, you can provide those separate from the medical history as we understand some patients are on more medications than the space allows for.
Patient Registration Form
The patient registration is three sections: demographic information, responsible party information, and insurance information. It is most helpful to us if you provide us with your insurance card (if possible, some insurances do not send cards out) so we can scan it to your chart. If not, we would need the following information in order to file claims with your insurance: Date of birth, social security number for the patient and policyholder (if not the same person as the patient), name of the employer the insurance is through (if applicable), Insurance ID number, group number, and name of insurance company. It is also helpful to have the address and phone number of the insurance company so we are able to file claims and contact the company in order to verify your coverage.
Medical History Form
The Medical History form will keep us updated on all your medical changes and current medications. Many times patients do not realize how closely the relationship between your medical and dental history, It is very important for us to have the most up to date information so we are able to provide you with the best care possible as well as keep you safe and healthy. If your medication list is complex or longer than space provided you may provide us with a separate list that we can scan into your chart. We ask all patients to update this form every five years, even if you have not had any changes to your health. If you have changes in your health more frequently than five years we ask you to update us with this information. We cannot stress enough how important it is we have the most up to date health information, as it can be vital to dental health and overall health, it can give us information to better treat and care for you as you are in our chair.
Contact Brownsburg Dental Professionals, PC Today!
We are incredibly excited you’ve decided to join us at Brownsburg Dental! Please do not hesitate to contact us at 317-852-9787 with any questions as you complete the forms, or prior—we’re always more than happy to help. We look forward to joining you on your journey to a healthy smile!