Patient Forms

For your convenience prior to your appointment, please click on the button below to complete and submit the patient forms online before your visit. If you are unable to complete the forms prior to your appointment, please plan to arrive 10-15 minutes early so that you can complete them in our office. 


New Patient Form (English)

Health History Update (English)

New Patient Form (Spanish)

Health History Update (Spanish)

HIPAA Notification

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Where to Find Us

Call: 937-642-8500

1055 West 5th St
Marysville, OH 43040

Email: info@loveyoursmiledentistry.com

1055 West 5th St|
Marysville, OH 43040

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