P: 616-392-1100
A: 291 W. LAKEWOOD BLVD. HOLLAND, MI 49424
If you would prefer to NOT fill out the online forms, please download and print the forms below. Please fill out all forms and bring
to your first visit.
Currently Online Forms are not available, please use the download links below to download and print out the forms to bring with you.
Please click on the links below to download forms to print out.
Patient Information and Health History Form Download Form
Medical History Form Download Form
Dental and Fluoride History Form Download Form
Consent for Treatment Form Download Form
Financial Policy Form Download Form
HIPAA Form Download Forms