Samia R. Shaikh, D.D.S., M.S.D
65 East Garner Road
Suite 600
Brownsburg, IN 46112
(317) 852-9299
FAX (317) 858-1251

WELCOME PACKAGE

We have made our new patient forms available for you online.  We recommend printing them and completing them at home.

Please remember to bring your forms with you for your first dental appointment.  If you have any problems printing them, please call us and we can mail or fax them to you.

 

Available forms:

• Welcome Letter

• Patient Registration

• Medical and Dental History

• Office Financial Policies, Consent and Agreement

• HIPPA

• Release of Records

• Consent for Treatment of a Minor

Please click on the form name above to open the form for printing.  To save a copy of the form to your computer, please right click on the form name and choose "Save As."

 

Call today for an appointment!

(317) 852-9299