Patient Forms

please click on any of the form below to download:

Form for Children

Form for Young Adult

Form for Adults

Financial Agreement Form

The Healthy Smiles Club Benefits Membership Form

General Medical Records Release

Health History Update Form

HIPAA Compliance Patient Consent Form

HIPAA-Privacy Notice Form

Comfort Menu Form

Watermark Medical ARES Questionnaire Form

Sedation Paperwork


Book a Dental Consultation in Mishawaka, Indiana

Want to learn more about a particular dental procedure or to find out what might be recommended based on your specific smile?

Contact us, whether you are interested in family dentistry or cosmetic dentistry in the Mishawaka, IN area. Dr. George Mighion and his team have an excellent reputation for excellence in dentistry with a gentle approach and a comfortable environment. No-obligation consultations are available to discuss your smile issues and concerns. Call our office today at 574.393.8663 to see what could be in store for your smile.