New Patients Forms

We highly recommend that you complete the following paperwork and e-mail or fax it to us at (952) 435-6291 prior to your initial appointment. Doing so will save you 20-30 minutes of time during your new patient appointment. By helping us prepare for your visitation, we can help to ensure that you have the best possible experience!
Please download the PDF files below and fill them out as required.

You can e-mail the patient and medical history forms to info@lakevillefamilydental.com or fax them to (952)435-6291.

Please click on the links below to download a printable PDF file:

Patient-Registration-Form
Payment-Policies-form
HIPAA-Form
Assignment-of-Benefits
Medical-History-Form
Receipt-of-Notice-Form

Thank you Lakeville Family Dental Centre!<

Our dental office is conveniently located in Lakeville off of Hwy 35W on exit CR-46 or 162nd West. See Our Location – Google Maps
We look forward to providing you and your family the best dental care in the Lakeville area and surrounding communities!