Patient Information

Important forms and information for new and existing Central Park Dentistry Patients

 

IMPORTANT UPDATE:  We have added a new COVID consent form for all new and current Central Park Dentistry patients that you will need to complete prior to your visit with us. 

Your first visit with us will of course be a little different than your subsequent visits.  This is of course because we need to gather some important information about you prior to getting started.  The main thing to be aware of is that you’ll need to complete some forms which we’ve included on this page for you to download and print out and complete prior to your first visit.  In the future our office will allow you to do all of this safely and securely online, but for now please print and bring them with you.

Don’t have a printer or way to complete these ahead of your visit?  No problem, just arrive early for your first visit and our staff will be happy to provide you with these forms at that time.  

 

1. Patient Information Form
2. Health History Form
3. Financial Agreement Form
4. Insurance Information Form

PRINTABLE FORMS (OFFLINE)

1.  Patient Information Form

2.  Health History Form

3.  Financial Agreement Form

4.  Insurance Information Form

Our Location

23 N Federal Ave, Mason City, IA

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Want to schedule an appointment with us?  Start here!