Patient Forms

We’re excited you’ve chosen our practice.

Download, fill out and email these forms to jtheurerddspc@gmail.com prior to coming in. This will speed up your first visit and make it more enjoyable. Thanks again for choosing Theurer Family Dental, we look forward to your visit.

Want to save money? Ask about our Health and Wellness Savings Plan! For only $275 a year for adults ($215 dollars a year for children) you can save money each time you visit. Our plan offers two complete professional cleanings and exams, annual required x-rays, and unlimited emergency exams and associated x-rays. In addition, you can save 30% on all general dentistry procedures, 20% on crowns, bridges, dentures, and Invisalign, and 10% savings on dental products. We even offer discounts for patients when referred to an approved specialist. Contact us to find out more!

Patient Registration Forms (click to download PDF)

Dental Health History Form (click to download PDF)

Financial Agreement Form (click to download PDF)