New Patient Form

We sincerely appreciate the trust you place in us when choosing Hoosier Pediatric Dental to care for your child's smile.

We know how tedious new patient forms can be when seeking treatment from a new medical professional.

In order to show our respect for your time and make life as easy as possible for you, we have ditched the clipboards and paperwork for an easy-to-use electronic form that can be completed and signed on any computer, phone, or tablet prior to your first visit with us.

We hope that this will also make the arrival for your first at our office easier.

After completing all sections of the form you will be automatically directed to electronically sign our treatment consent form.

If you have any trouble filling out our new patient form, please do not hesitate to contact our office at (317) 516-5184 for the Fishers office and (765) 673-0633 for the Marion office.