Child Registration

Follow these steps in order to register a minor patient/patients. Feel free to contact us with any questions, call our office at 812-738-2166. If you haven’t scheduled your appointment yet, Jamie from our office will be in touch with you as soon as your forms are submitted. If you have already scheduled your appointment, we look forward to seeing you soon!

Step 1: Child Registration Form

Step 2: Child Dental & Medical History Form

Step 3: Treatment of Minor Children Consent Form