Patient Forms


Fill Out Patient Forms for Your Visit to Your Dentist in Indianapolis

For your convenience, our patients are able to print and fill out the forms below in the comfort of their own homes. The reason for this is so each patient is able to hand in these forms when they arrive for their appointment and be able to spend more time with their general dentist in Indianapolis. This appointment time is for you and your dentist in Indianapolis! Discuss any and all questions, comments and concerns that you may have.


Patient Information / Health History

Patient Consent / HIPPA / Financial Agreement

Notice of Privacy Practice 


Tenth Street Family Dental
6919 E. 10th Street, Suite A1
Indianapolis, IN 46219
Phone: 317-358-8885
Fax: (317) 358-8886

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