Mill Creek Family Dental

Patient Information

Thank you for choosing Mill Creek Family Dental.

We are excited to be you and your family’s Dental office. Before your first dental visit we will need information about you. This information will help us provide you with the best possible service. We will ask you to fill out forms in our office before your first visit, OR if you wish to save time, we encourage you to print a copy of the forms below, read them over, complete them where necessary and bring them with you to your first appointment. This will eliminate the need of filling out paperwork in our office at the time of your visit.

Please print out one of each of the following:

Patient Registration Form

HIPAA Consent Form

Insurance Estimate Consent

Privacy Practices Acknowledgement

You will need to have Adobe Acrobat Reader installed on your computer to view some of these documents. You can download it free from the Adobe Web site.

Get Adobe Reader

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Patient Education

A good understanding of your dental health is essential. We want you to know what we're doing, and why! We pride ourselves in having the most well-educated patients regarding their dental health and treatment. Below, you will find explanations of common concerns and procedures that will demonstrate the importance of dental health, how it relates to you, and what you can do to obtain a healthy mouth and your best smile.

Educational Articles:

Thank you for taking the time to learn more about your dental health. If you have any additional questions or concerns, please call us. We look forward to serving you!


Call for an appointment today! (765) 471-6025


3667 Braddock Drive, Suite B, Lafayette IN 47909  :  (765) 471-6025  :  Monday - Thursday: 8am - 5pm, Friday: 8am - 1pm
Copyright © 2011 Mill Creek Family Dental. All rights reserved.

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