Patient Registration

Click on the Links Below Per Your Location for New Patient Registration Forms:

Pre-register safely from home, using our secure, online forms. Choose the office for your appointment, fill out as completely as possible, and click Submit when done. You will then have the opportunity to securely upload an image of your insurance card.

Patient Registration Form for Plymouth Office

Patient Registration Form for Ann Arbor Office

Patient Registration Form for Chelsea Office

Restore your smile in South East Michigan today!

Book an appointment or Call our offices for any questions.

The security of your information is important to us.