Waterloo Family Dental


When you arrive for your first visit, please be prepared to complete all insurance and health information forms that will allow us to begin your dental treatment. We will ask you to fill out several forms that will get you acquainted with our office. If you’d like to get started with your paperwork, you can fill out and submit the form below.

Your initial exam will last approximately an hour and a half. Oral hygiene instructions will be provided along with suggestions to help you care for your teeth. In most cases, we will also clean your teeth on this visit and provide an evaluation that will outline your existing dental problems and proposed treatment.

Please complete the New Patient online form and submit it to us before your first appointment. This is a fillable form and you will need Acrobat Reader to be able to send the completed form to us. Get Acrobat Reader here.

  1. Save this document to your computer.
  2. Open the PDF document in Adobe Acrobat Reader and fill out the fields with your keyboard.
  3. Select submit at the bottom of the form when all information has been completed. This will open up your email client and send the filled out form to us.
  4. Save the filled out form to your computer for reference.