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First Time Patients

If you're a new patient to Ellettsville Dental Center and you have your first appointment scheduled, you may print out the Registration and Health History form to save you some time. Please click on the link below, print this out, fill in the appropriate information and bring it with you to your first appointment.

Registration and Health History form (PDF, 107 kb)
Privacy Statement (PDF, 130 kb)

(These documents require that you have Adobe Acrobat Reader installed on your computer. If you do not have it installed, you can download it for free from Adobe's web site.)

Phone: (812)876-7330 Toll-free (877)876-7330 5915 W. State Rd. 46, Ellettsville, IN 47429