Complete Care. One Location. Current Patients: 317-247-9512 New Patients: 317-434-3989

  • Family at dentist office
  • The staff is so polite, friendly, capable and caring. I always look forward to coming in for my checkups. - Carol M.

Medical History Form

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(NOTE: This form takes approximately 6 minutes.)

Understand that this form appears more lengthy than it's hard copy original because the information needs to be asked in a linear fashion for a web form but will actually save you time at our offices and will not take you as long to complete as you think. Make sure you fill in all required fields or the form will not advance. All information is used by our office only and is not shared with third parties.

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